Healthcare Provider Details

I. General information

NPI: 1720798077
Provider Name (Legal Business Name): RELIANCE WOMENS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MEDICAL CENTER WAY
SOMERS POINT NJ
08244-2306
US

IV. Provider business mailing address

545 TILTON RD
NORTHFIELD NJ
08225-1217
US

V. Phone/Fax

Practice location:
  • Phone: 609-653-1016
  • Fax: 609-653-1064
Mailing address:
  • Phone: 609-204-9818
  • Fax:

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: DR. JON REGIS
Title or Position: OWNER
Credential: MD
Phone: 772-646-3841