Healthcare Provider Details
I. General information
NPI: 1902851314
Provider Name (Legal Business Name): REGIONAL WOMENS HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date: 01/05/2007
Reactivation Date: 03/02/2007
III. Provider practice location address
400 LIPPINCOTT DR SUITE 130
MARLTON NJ
08053-4161
US
IV. Provider business mailing address
PO BOX 536
VOORHEES NJ
08043-0536
US
V. Phone/Fax
- Phone: 856-596-2233
- Fax: 856-596-2411
- Phone: 856-669-6050
- Fax: 856-651-0794
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANK
J
CASO
Title or Position: CREDENTIALING
Credential:
Phone: 856-669-6050