Provider Demographics
NPI:1922077072
Name:WITTIG, LORAYN KAYE (MD)
Entity Type:Individual
Prefix:DR
First Name:LORAYN
Middle Name:KAYE
Last Name:WITTIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 BURTNER RD
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2845
Mailing Address - Country:US
Mailing Address - Phone:724-226-1400
Mailing Address - Fax:
Practice Address - Street 1:1604 BURTNER RD
Practice Address - Street 2:SUITE 2300
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2845
Practice Address - Country:US
Practice Address - Phone:724-226-1400
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069086L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH17723Medicare UPIN
PA038291PD9Medicare ID - Type Unspecified