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General NPI Number Information
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NPI Number | 1023162385
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Entity Type | Organization
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Legal Business Name | PROSPECT WOMEN'S HEALTH CENTER, LLC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 77 PROSPECT AVE 1B
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City | HACKENSACK
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State | NJ
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Zip | 07601-1913
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Country | US
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Telephone | 201-342-7002
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Fax | 201-342-7055
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Provider Business Mailing Address
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Address Line | 77 PROSPECT AVE SUITE#1B
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City | HACKENSACK
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State | NJ
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Zip | 07601-1262
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Country | US
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Telephone | 201-342-7002
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Fax | 201-342-7055
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Authorized Official
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Title or Position | OFFICER
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Name | DR. WALEED MOHAMED ABDELGHANI
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Credential | M.D.
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Telephone | 201-342-7002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 1270009
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License Number State | NJ
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