Healthcare Provider Details

I. General information

NPI: 1043176563
Provider Name (Legal Business Name): ONCE UPON A TEMP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 SHARON NEW CASTLE RD
FARRELL PA
16121-2419
US

IV. Provider business mailing address

919 SHARON NEW CASTLE RD
FARRELL PA
16121-2419
US

V. Phone/Fax

Practice location:
  • Phone: 724-308-7476
  • Fax:
Mailing address:
  • Phone: 724-308-7476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LISA TOVCIMAK
Title or Position: PRESIDENT
Credential: PHDHP
Phone: 814-227-8172