MEDICARE: AVALON. A CENTER FOR WOMEN'S HEALTH

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
1	367A00000X	Advanced Practice Midwife		NJ

General Provider Information

NPI Number	:	1760424477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVALON. A CENTER FOR WOMEN'S HEALTH

Provider Business Mailing Address
First Line	:	25 LINDSLEY DRIVE SUITE 201A
Second Line	:	AVALON. A CENTER FOR WOMAN'S HEALTH
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-4456
Country	:	US
Telephone Number	:	973-998-7922
Fax Number	:	973-998-7925

Provider Business Practice Location Address
First Line	:	25 LINDSLEY DRIVE, SUITE 201A
Second Line	:	AVALON . A CENTER FOR WOMAN'S HEALTH
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-4456
Country	:	US
Telephone Number	:	973-998-7922
Fax Number	:	973-998-7925

Authorized Official
Title or Position	:	CNM/OWNER
Name	:	MRS. DONNA C ROOSA
Credential	:	CNM. MS
Telephone Number	:	973-998-7922

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	03/10/2016

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Directions to “AVALON. A CENTER FOR WOMEN'S HEALTH ” Practice Location

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