MEDICARE: WOMENS CARE CONSULTANTS, PC

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	207V00000X	Obstetrics & Gynecology Physician	OSO12339	PA

General Provider Information

NPI Number	:	1356534549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMENS CARE CONSULTANTS, PC

Provider Business Mailing Address
First Line	:	611 MORGAN HWY
Second Line	:
City	:	SOUTH ABINGTON TOWNSHIP
State	:	PA
Zip	:	18411-9128
Country	:	US
Telephone Number	:	570-586-6637
Fax Number	:	570-587-0547

Provider Business Practice Location Address
First Line	:	611 MORGAN HIGHWAY
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-9139
Country	:	US
Telephone Number	:	570-586-6637
Fax Number	:	570-587-0547

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	BARRY L GREEN
Credential	:	DO
Telephone Number	:	570-586-6637

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	05/24/2011

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