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1992700553

NPI Code Detail

MEDICARE: HANNA DMOCHOWSKA MD

MEDICARE: HANNA DMOCHOWSKA MD

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	207Q00000X	Family Medicine Physician	MD053791L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	080187044	OTHER	PA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	205112	OTHER	PA	UPMC
2	2224471	OTHER	OH	OH MEDICAL ASSISTANCE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	00026080501	OTHER	NY	UNIVERA
5	02149315	OTHER	NY	NY MEDICAL ASSISTANCE
6	789965	OTHER	PA	BLUE SHIELD
7	65273	OTHER	PA	UNISON
8	P000092	OTHER	PA	GATEWAY
10	3119426	OTHER	PA	AETNA

General Provider Information

NPI Number	:	1992700553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNA DMOCHOWSKA MD

Provider Business Mailing Address
First Line	:	4500 PINE AVE
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16504-2316
Country	:	US
Telephone Number	:	814-877-5800
Fax Number	:	814-877-5809

Provider Business Practice Location Address
First Line	:	4500 PINE AVE
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16504-2316
Country	:	US
Telephone Number	:	814-877-5800
Fax Number	:	814-877-5809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	03/18/2013

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Directions to “ HANNA DMOCHOWSKA MD” Practice Location

Language	Start Address	Practice Location

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