Healthcare Provider Details

I. General information

NPI: 1366832941
Provider Name (Legal Business Name): DELAWARE COUNTY WOMENS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER BLVD CCMC ANNEX - ALEXANDER SILBERMAN CENTER, 4TH FLOOR
CHESTER PA
19013-3902
US

IV. Provider business mailing address

601 CHAPEL AVE E CREDENTIALING DEPT
CHERRY HILL NJ
08034-1454
US

V. Phone/Fax

Practice location:
  • Phone: 856-356-4025
  • Fax: 856-356-4038
Mailing address:
  • Phone: 856-356-4025
  • Fax: 856-356-4038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA LAZARUS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 856-356-4000