Healthcare Provider Details
I. General information
NPI: 1972602852
Provider Name (Legal Business Name): SARIT O. ASCHKENAZI-STEINBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/21/2006
Last Update Date: 10/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
785 SUMMIT AVE STE 101 PROHEALTH CARE WOMEN'S CENTER
OCONOMOWOC WI
53066-3844
US
IV. Provider business mailing address
785 SUMMIT AVE STE 101 PROHEALTH CARE WOMEN'S CENTER
OCONOMOWOC WI
53066-3844
US
V. Phone/Fax
- Phone: 262-569-0345
- Fax: 262-569-0333
- Phone: 262-569-0345
- Fax: 262-569-0333
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 036-114484 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VF0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician |
| License Number | 52047 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: