Healthcare Provider Details

I. General information

NPI: 1194045021
Provider Name (Legal Business Name): CAPITAL HEALTH WOMENS HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 WHITEHORSE MERCERVILLE RD SUITE 220
HAMILTON NJ
08619-3835
US

IV. Provider business mailing address

PO BOX 8500-8482
PHILADELPHIA PA
19178-0001
US

V. Phone/Fax

Practice location:
  • Phone: 609-588-5059
  • Fax: 609-528-8868
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: NATHAN BOSK
Title or Position: VP AMBULATORY SERVICES DIVISION
Credential:
Phone: 609-278-5438