Healthcare Provider Details

I. General information

NPI: 1619923695
Provider Name (Legal Business Name): REGIONAL WOMENS HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date: 01/05/2007
Reactivation Date: 03/02/2007

III. Provider practice location address

702 E MAIN ST
MOORESTOWN NJ
08057
US

IV. Provider business mailing address

PO BOX 536
VOORHEES NJ
08043-0536
US

V. Phone/Fax

Practice location:
  • Phone: 856-642-6580
  • Fax: 856-273-8372
Mailing address:
  • Phone: 856-669-6050
  • Fax: 856-651-0794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FRANK J CASO
Title or Position: CEO
Credential:
Phone: 856-669-6050