=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609745421
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FEMGEVITY OF NEW JERSEY PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2025
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 841 FRANKLIN AVE
-----------------------------------------------------
City | FRANKLIN LAKES
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07417-1418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-301-7776
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 337 HILLTOP RD
-----------------------------------------------------
City | MENDHAM
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07945-2908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-902-8708
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO & FOUNDER
-----------------------------------------------------
Name | MRS. MICHELE J WISPELWEY
-----------------------------------------------------
Credential | MBA
-----------------------------------------------------
Telephone | 973-902-8708
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------