Individual
LAUREN ELIZABETH WYCHOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6000
Mailing address
22 PHAETON DR, PENFIELD, NY 14526-1218
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
10/28/2022
Last updated
10/28/2022
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