Healthcare Provider Details

I. General information

NPI: 1043254410
Provider Name (Legal Business Name): WHITE OAK OB GYN SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1966 LINCOLN WAY SUITE 100
WHITE OAK PA
15131-2416
US

IV. Provider business mailing address

1966 LINCOLN WAY SUITE 100
WHITE OAK PA
15131-2416
US

V. Phone/Fax

Practice location:
  • Phone: 412-673-3800
  • Fax: 412-673-5848
Mailing address:
  • Phone: 412-673-3800
  • Fax: 412-673-5848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number016883E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number016883E
License Number StatePA

VIII. Authorized Official

Name: DR. ROCCO A FULCINITI
Title or Position: PHYSCIAN
Credential: M.D.
Phone: 412-673-3800