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NPI Code Detail

MEDICARE: EVELYN W WHITE MD

MEDICARE: EVELYN W WHITE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician01047375AIN
2207V00000XObstetrics & Gynecology Physician25MA08626900NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1160058615OTHERRAILROAD

General Provider Information

NPI Number : 1134197395
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN W WHITE MD
Provider Business Mailing Address
First Line : 21 MARKET ST
Second Line :
City : PATERSON
State : NJ
Zip : 07501-1723
Country : US
Telephone Number : 973-754-4200
Fax Number : 973-754-4298
Provider Business Practice Location Address
First Line : 21 MARKET ST
Second Line :
City : PATERSON
State : NJ
Zip : 07501-1723
Country : US
Telephone Number : 973-754-4200
Fax Number : 973-754-4298
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 05/02/2014

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Directions to “ EVELYN W WHITE MD” Practice Location

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