Healthcare Provider Details

I. General information

NPI: 1639657588
Provider Name (Legal Business Name): CHERRY HILL WOMEN'S CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 KINGS HWY N
CHERRY HILL NJ
08034-1502
US

IV. Provider business mailing address

601 CHAPEL AVE E
CHERRY HILL NJ
08034-1454
US

V. Phone/Fax

Practice location:
  • Phone: 856-667-5910
  • Fax: 856-667-8304
Mailing address:
  • Phone: 856-356-4001
  • Fax: 856-414-1660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number22445
License Number StateNJ

VIII. Authorized Official

Name: ANGELA LAZARUS
Title or Position: COO
Credential:
Phone: 568-356-4001