MEDICARE: WHITE OAK OB GYN SERVICES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	016883E	PA
2	207VX0000X	Obstetrics Physician	016883E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	528035	OTHER	PA	HIGHMARK BC/BS

General Provider Information

NPI Number	:	1043254410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITE OAK OB GYN SERVICES PC

Provider Business Mailing Address
First Line	:	1966 LINCOLN WAY
Second Line	:	SUITE 100
City	:	WHITE OAK
State	:	PA
Zip	:	15131-2416
Country	:	US
Telephone Number	:	412-673-3800
Fax Number	:	412-673-5848

Provider Business Practice Location Address
First Line	:	1966 LINCOLN WAY
Second Line	:	SUITE 100
City	:	WHITE OAK
State	:	PA
Zip	:	15131-2416
Country	:	US
Telephone Number	:	412-673-3800
Fax Number	:	412-673-5848

Authorized Official
Title or Position	:	PHYSCIAN
Name	:	DR. ROCCO A FULCINITI
Credential	:	M.D.
Telephone Number	:	412-673-3800

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	09/11/2025

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