Basic Information
Provider Information
NPI: 1386760783
EntityType: 2
ReplacementNPI:  
OrganizationName: REGIONAL WOMEN'S HEALTH GROUP, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: THE OB GYN SPECIALISTS
OtherOrganizationType: 3
OtherLastName:  
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OtherLastNameType:  
Mailing Information
Address1: PO BOX 536
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080430536
CountryCode: US
TelephoneNumber: 8566696050
FaxNumber: 8566510794
Practice Location
Address1: 120 CARNIE BLVD
Address2: SUITE 5
City: VOORHEES
State: NJ
PostalCode: 080434520
CountryCode: US
TelephoneNumber: 8568741114
FaxNumber: 8568749555
Other Information
ProviderEnumerationDate: 03/21/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CASO
AuthorizedOfficialFirstName: FRANK
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 8566696050
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate:  

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

No ID Information.


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