1295807659 NPI number — WOMENS GROUP FOR OBSTETRICS AND GYNECOLOGY, PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295807659 NPI number — WOMENS GROUP FOR OBSTETRICS AND GYNECOLOGY, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOMENS GROUP FOR OBSTETRICS AND GYNECOLOGY, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295807659
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2301 E EVESHAM RD
Provider Second Line Business Mailing Address:
BUILDING 800, SUITE 122
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043-4501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-770-9300
Provider Business Mailing Address Fax Number:
856-770-9518

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2301 EVESHAM ROAD
Provider Second Line Business Practice Location Address:
BUILDING 800 STE 122
Provider Business Practice Location Address City Name:
VOORHEES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-770-9300
Provider Business Practice Location Address Fax Number:
856-770-9518
Provider Enumeration Date:
11/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINEZ
Authorized Official First Name:
WENDY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
856-770-9300

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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