1851386528 NPI number — DR. KAREN L WOOLAWAY AU.D.

Table of content: DR. KAREN L WOOLAWAY AU.D. (NPI 1851386528)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851386528 NPI number — DR. KAREN L WOOLAWAY AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOOLAWAY
Provider First Name:
KAREN
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851386528
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/23/2006
NPI Reactivation Date:
03/29/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 GUTHRIE SQ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAYRE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18840-1625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-888-5858
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 S ELMER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAYRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-887-2849
Provider Business Practice Location Address Fax Number:
570-887-2244
Provider Enumeration Date:
09/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  001293-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: AT005935 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PO10001293 . This is a "BLUE MILLION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000576048002 . This is a "BLUE CROSS BLUE SHEILD GM" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000576048006 . This is a "COMMUNITY BLUE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0010490 . This is a "GROUP HEALTH INC. GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 103209AI . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000576048007 . This is a "BLUE CROSS BLUE SHIELD WE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9390234 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PO1001293 . This is a "BC/BS ROCH HE SERVICES" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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