Provider Demographics
NPI:1972296580
Name:WOMEN'S HEALTH SERVICES OF ROARING SPRING
Entity Type:Organization
Organization Name:WOMEN'S HEALTH SERVICES OF ROARING SPRING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BISACCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-710-8140
Mailing Address - Street 1:878 PINE HEIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-2105
Mailing Address - Country:US
Mailing Address - Phone:814-710-8140
Mailing Address - Fax:814-224-2397
Practice Address - Street 1:878 PINE HEIGHTS ST
Practice Address - Street 2:
Practice Address - City:ROARING SPRING
Practice Address - State:PA
Practice Address - Zip Code:16673-2105
Practice Address - Country:US
Practice Address - Phone:814-710-8140
Practice Address - Fax:814-224-2397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty