1508855362 NPI number — WOMENS HEALTH SPECIALISTS LLP

Table of content: (NPI 1508855362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508855362 NPI number — WOMENS HEALTH SPECIALISTS LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOMENS HEALTH SPECIALISTS LLP
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:
1508855362
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
615 N SEWARD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUBURN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13021-2107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-253-9749
Provider Business Mailing Address Fax Number:
315-252-3911

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
615 N SEWARD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13021-2107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-253-9749
Provider Business Practice Location Address Fax Number:
315-253-2614
Provider Enumeration Date:
10/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MURPHY
Authorized Official First Name:
EILEEN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
315-253-9749

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1629501 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".