Provider Demographics
NPI:1003893314
Name:WOMEN'S HEALTH AND LASER CARE PC
Entity type:Organization
Organization Name:WOMEN'S HEALTH AND LASER CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUGHEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-944-6055
Mailing Address - Street 1:2918 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-1917
Mailing Address - Country:US
Mailing Address - Phone:814-944-6055
Mailing Address - Fax:814-944-1912
Practice Address - Street 1:2918 6TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-1917
Practice Address - Country:US
Practice Address - Phone:814-944-6055
Practice Address - Fax:814-944-1912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4102OtherUPMC
PA68867OtherTHREE RIVERS-UNISON
PA1008909OtherGATEWAY
PA1007771320002Medicaid
PA1007771320002Medicaid