Organization
WOMEN'S HEALTH AND LASER CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN J BISACCO MD (PHYSICIAN CEO)
(814) 944-6055
Entity
Organization
Contact information
Practice address
2918 6TH AVE, ALTOONA, PA 16602-1917
(814) 944-6055
(814) 944-1912
Mailing address
2918 6TH AVE, ALTOONA, PA 16602-1917
(814) 944-6055
(814) 944-1912
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
021591
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100777132
—
PA
Enumeration date
07/03/2008
Last updated
07/03/2008
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