Healthcare Provider Details
I. General information
NPI: 1598940439
Provider Name (Legal Business Name): THE WOMEN'S GROUP OF RIDGEWOOD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2008
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 W RIDGEWOOD AVE SUITE 205
PARAMUS NJ
07652-2359
US
IV. Provider business mailing address
1 W RIDGEWOOD AVE SUITE 205
PARAMUS NJ
07652-2359
US
V. Phone/Fax
- Phone: 201-251-2323
- Fax: 201-251-2325
- Phone: 201-251-2323
- Fax: 201-251-2325
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | MA062434 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
MONICA
LYNN
MEYER
Title or Position: DIRECTOR
Credential: M.D.
Phone: 201-251-2323