Provider Demographics
NPI:1922038140
Name:WESTERN PA WOMEN'S HEALTHCARE ASSOCIATES
Entity Type:Organization
Organization Name:WESTERN PA WOMEN'S HEALTHCARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ICHIKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-466-2115
Mailing Address - Street 1:850 CLAIRTON BLVD
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4567
Mailing Address - Country:US
Mailing Address - Phone:412-466-2115
Mailing Address - Fax:412-466-4668
Practice Address - Street 1:850 CLAIRTON BLVD
Practice Address - Street 2:SUITE 3100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4567
Practice Address - Country:US
Practice Address - Phone:412-466-2115
Practice Address - Fax:412-466-4668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019038010004Medicaid
PA688141Medicare ID - Type UnspecifiedGROUP ID