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General NPI Number Information
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NPI Number | 1093807778
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Entity Type | Organization
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Legal Business Name | WOMENS HEALTHCARE & AESTHETICS P C
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 400 NEW HAMPSHIRE AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4509
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Country | US
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Telephone | 732-364-1290
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Fax | 732-905-8649
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Provider Business Mailing Address
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Address Line | 400 NEW HAMPSHIRE AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4509
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Country | US
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Telephone | 732-364-1290
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Fax | 732-905-8649
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Authorized Official
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Title or Position | OWNER
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Name | NILES EDWARD CHOPER
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Credential | MD
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Telephone | 732-364-1290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MA065067
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License Number State | NJ
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