Healthcare Provider Details
I. General information
NPI: 1578518502
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: 02/10/2014
Certification Date:
Deactivation Date: 01/05/2007
Reactivation Date: 03/02/2007
III. Provider practice location address
100 INDEPENDENCE BLVD STE 100
SICKLERVILLE NJ
08081-1039
US
IV. Provider business mailing address
227 LAUREL RD STE 300
VOORHEES NJ
08043-8303
US
V. Phone/Fax
- Phone: 856-424-2477
- Fax: 856-424-2649
- Phone: 856-669-6050
- Fax: 856-651-0794
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANK
J
CASO
Title or Position: CEO
Credential:
Phone: 856-669-6050