Healthcare Provider Details

I. General information

NPI: 1306944418
Provider Name (Legal Business Name): WHITE PLAINS OBSTETRICS & GYNECOLOGY ASSOC.,LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 N BROADWAY
WHITE PLAINS NY
10601-2214
US

IV. Provider business mailing address

15 N BROADWAY
WHITE PLAINS NY
10601-2214
US

V. Phone/Fax

Practice location:
  • Phone: 914-328-8444
  • Fax: 914-328-8414
Mailing address:
  • Phone: 914-328-8444
  • Fax: 914-328-8414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: F.MICHAEL SHAW
Title or Position: PARTNER
Credential: MD
Phone: 914-328-8444