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General NPI Number Information
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NPI Number | 1588471643
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Entity Type | Organization
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Legal Business Name | ELECTRA WOMENS HEALTH MEDICAL NJ PC
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1400 HOOPER AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08753-2981
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Country | US
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Telephone | 202-524-8706
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Fax |
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Provider Business Mailing Address
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Address Line | 228 PARK AVE S # 49409
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City | NEW YORK
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State | NY
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Zip | 10003-1502
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Country | US
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Telephone | 202-524-8706
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Fax |
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Authorized Official
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Title or Position | COO & ASST TREASURER
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Name | JANNINE VERSI
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Credential |
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Telephone | 646-760-6669
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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 |
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License Number State |
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