MEDICARE: DARIA HELENA LIN-GUELIG PA-C

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	363AM0700X	Medical Physician Assistant	MA001140L	PA

General Provider Information

NPI Number	:	1447263462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARIA HELENA LIN-GUELIG PA-C

Provider Business Mailing Address
First Line	:	22 WALNUT ST
Second Line	:	LAUREL HEALTH CENTER ADMINISTRATION ATTN:MARIA SMITH
City	:	WELLSBORO
State	:	PA
Zip	:	16901-1526
Country	:	US
Telephone Number	:	570-723-0621
Fax Number	:	570-724-1197

Provider Business Practice Location Address
First Line	:	103 WEST AVE
Second Line	:	WELLSBORO LAUREL HEALTH CENTER
City	:	WELLSBORO
State	:	PA
Zip	:	16901-1358
Country	:	US
Telephone Number	:	570-724-1010
Fax Number	:	570-724-3970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/08/2007

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