MEDICARE: HALEE L. ONDER 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	MA051724	PA

General Provider Information

NPI Number	:	1508851312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEE L. ONDER PA-C

Provider Business Mailing Address
First Line	:	6998 CRIDER RD
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-2390
Country	:	US
Telephone Number	:	724-778-3627
Fax Number	:	724-778-3630

Provider Business Practice Location Address
First Line	:	6998 CRIDER RD
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-2390
Country	:	US
Telephone Number	:	724-778-3627
Fax Number	:	724-778-3630

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	12/05/2012

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