Healthcare Provider Details

I. General information

NPI: 1407863699
Provider Name (Legal Business Name): WOMEN'S HEALTH CARE GROUP OF PA, MAIN LINE WOMEN'S HEALTH CARE DIV.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 E LANCASTER AVE
BRYN MAWR PA
19010-1451
US

IV. Provider business mailing address

1030 E LANCASTER AVE
BRYN MAWR PA
19010-1451
US

V. Phone/Fax

Practice location:
  • Phone: 610-525-3098
  • Fax: 610-525-4932
Mailing address:
  • Phone: 610-525-3098
  • Fax: 610-525-4932

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: JANINE JONES
Title or Position: BOOKKEEPING COORDINATOR
Credential:
Phone: 610-525-3098