Basic Information
Provider Information
NPI: 1346296316
EntityType: 2
ReplacementNPI:  
OrganizationName: REGIONAL WOMENS HEALTH GROUP LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: RWHG LAWRENCE OB GYN
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 536
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080430536
CountryCode: US
TelephoneNumber: 8566696050
FaxNumber: 8566510794
Practice Location
Address1: 123 FRANKLIN CORNER RD
Address2: SUITE 214
City: LAWRENCEVILLE
State: NJ
PostalCode: 08648
CountryCode: US
TelephoneNumber: 6098961400
FaxNumber: 6098963986
Other Information
ProviderEnumerationDate: 05/25/2006
LastUpdateDate: 10/18/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate: 01/05/2007
NPIReactivationDate: 03/02/2007
ProviderGenderCode:  
AuthorizedOfficialLastName: CASO
AuthorizedOfficialFirstName: FRANK
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 8566696050
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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