Basic Information
Provider Information | |||||||||
NPI: | 1245646306 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | REGIONAL WOMEN'S HEALTH GROUP,,LLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | RWHG WEST ESSEX OB GYN ASSOCIATES | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 227 LAUREL RD | ||||||||
Address2: | SUITE 300 | ||||||||
City: | VOORHEES | ||||||||
State: | NJ | ||||||||
PostalCode: | 080438303 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8566696050 | ||||||||
FaxNumber: | 8566510794 | ||||||||
Practice Location | |||||||||
Address1: | 22 OLD SHORT HILLS RD | ||||||||
Address2: | SUITE 112 | ||||||||
City: | LIVINGSTON | ||||||||
State: | NJ | ||||||||
PostalCode: | 070395604 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9737401330 | ||||||||
FaxNumber: | 9737401394 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/09/2014 | ||||||||
LastUpdateDate: | 10/16/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: | 08/14/2014 | ||||||||
NPIReactivationDate: | 10/16/2014 | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | CASO | ||||||||
AuthorizedOfficialFirstName: | FRANK | ||||||||
AuthorizedOfficialMiddleName: | J | ||||||||
AuthorizedOfficialTitleorPosition: | CEO | ||||||||
AuthorizedOfficialTelephone: | 8566696050 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | MR. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X |   |   | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
No ID Information.