Healthcare Provider Details

I. General information

NPI: 1184930851
Provider Name (Legal Business Name): ADVANCED WOMENS HEALTHCARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 PROSPECT AVE SUITE 15
HACKENSACK NJ
07601-2255
US

IV. Provider business mailing address

140 PROSPECT AVE SUITE 15
HACKENSACK NJ
07601-2255
US

V. Phone/Fax

Practice location:
  • Phone: 201-880-6181
  • Fax: 201-880-6184
Mailing address:
  • Phone: 201-880-6181
  • Fax: 201-880-6184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA08358700
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ULAS BOZDOGAN
Title or Position: OWNER
Credential: M.D.
Phone: 201-880-6181