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General NPI Number Information
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NPI Number | 1255649950
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Entity Type | Organization
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Legal Business Name | WOMEN'S MEDICAL CARE SERVICES, P.C.
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 2 TAMARA CT
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City | MELVILLE
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State | NY
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Zip | 11747-4146
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Country | US
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Telephone | 631-643-5382
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Fax |
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Provider Business Mailing Address
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Address Line | 2 TAMARA CT
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City | MELVILLE
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State | NY
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Zip | 11747-4146
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Country | US
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Telephone | 631-643-5382
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. MAX JEAN-GILLES
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Credential | M.D.
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Telephone | 631-643-5382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 165341
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 165341
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License Number State | NY
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