Basic Information
| Provider Information | |||||||||
| NPI: | 1629023122 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REGIONAL WOMENS HEALTH GROUP LLC | ||||||||
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| OtherOrganizationName: | RICHARD DITTRICH DO | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 LAUREL RD | ||||||||
| Address2: | STE 300 | ||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080438303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566696050 | ||||||||
| FaxNumber: | 8566510794 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 WHITE HORSE RD | ||||||||
| Address2: | BLDG 612 GLENDALE EXECUTIVE CAMPUS | ||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080434406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564359090 | ||||||||
| FaxNumber: | 8564358753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 03/05/2012 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 01/05/2007 | ||||||||
| NPIReactivationDate: | 03/02/2007 | ||||||||
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| AuthorizedOfficialLastName: | CASO | ||||||||
| AuthorizedOfficialFirstName: | FRANK | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8566696050 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.