Healthcare Provider Details

I. General information

NPI: 1295799575
Provider Name (Legal Business Name): TRI-COUNTY WOMEN'S HEALTHCARE, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OLD YORK RD SUITE 3-108
JENKINTOWN PA
19046-3606
US

IV. Provider business mailing address

100 OLD YORK RD SUITE 3-108
JENKINTOWN PA
19046-3606
US

V. Phone/Fax

Practice location:
  • Phone: 215-885-5600
  • Fax: 215-885-1721
Mailing address:
  • Phone: 215-885-5600
  • Fax: 215-885-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAY M SIVITZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 215-885-5600