Healthcare Provider Details

I. General information

NPI: 1891963658
Provider Name (Legal Business Name): WOMEN'S CARE PHYSICIANS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 JEFFERSON AVE
ELIZABETH NJ
07201-2474
US

IV. Provider business mailing address

225 WILLIAMSON ST
ELIZABETH NJ
07202-3625
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-5500
  • Fax: 908-558-0190
Mailing address:
  • Phone: 908-994-5197
  • Fax: 908-994-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNJ

VIII. Authorized Official

Name: MRS. LANETTE LABOY
Title or Position: OFFICE MANAGER
Credential:
Phone: 908-994-5197