Provider Demographics
NPI:1922374107
Name:WEGRZYNIAK, LINDSEY JO (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:JO
Last Name:WEGRZYNIAK
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:1 LEMOYNE SQ
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1230
Mailing Address - Country:US
Mailing Address - Phone:717-737-4511
Mailing Address - Fax:717-909-6659
Practice Address - Street 1:1 LEMOYNE SQ
Practice Address - Street 2:SUITE 201
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1230
Practice Address - Country:US
Practice Address - Phone:717-737-4511
Practice Address - Fax:717-909-6659
Is Sole Proprietor?:No
Enumeration Date:2012-04-01
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS017830207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA003406782OtherHIGHMARK BLUE SHIELD
PA50141795OtherCAPITAL BLUE CROSS
PA7076197OtherCIGNA
PA511929FQXMedicare PIN