Healthcare Provider Details

I. General information

NPI: 1295002244
Provider Name (Legal Business Name): GWENDOLYN L MCCOMSEY PCD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2011
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N LIME ST APT 2 FRONT
LANCASTER PA
17602-3177
US

IV. Provider business mailing address

30 N LIME ST APT 2 FRONT
LANCASTER PA
17602-3177
US

V. Phone/Fax

Practice location:
  • Phone: 717-371-7123
  • Fax:
Mailing address:
  • Phone: 717-371-7123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: