Healthcare Provider Details

I. General information

NPI: 1245084250
Provider Name (Legal Business Name): ELEKTRA WOMEN'S HEALTH MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 MACKENZIE WAY
CRANBERRY TOWNSHIP PA
16066-5338
US

IV. Provider business mailing address

228 PARK AVE S
NEW YORK NY
10003-1502
US

V. Phone/Fax

Practice location:
  • Phone: 646-760-6669
  • Fax:
Mailing address:
  • Phone: 202-524-8706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JANNINE VERSI
Title or Position: COO
Credential:
Phone: 646-760-6669