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General NPI Number Information
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NPI Number | 1598016974
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Entity Type | Organization
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Legal Business Name | WOMEN MEDICAL HEALTH CARE & DIAGNOSTICS PC
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 15915 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-3935
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Country | US
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Telephone | 718-739-3225
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Fax | 718-739-3238
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Provider Business Mailing Address
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Address Line | 15915 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-3935
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Country | US
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Telephone | 718-739-3225
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Fax | 718-739-3238
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARCEL A AJAH
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Credential | M.D.
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Telephone | 718-739-3225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 220777
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License Number State | NY
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