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General NPI Number Information
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NPI Number | 1649399486
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Entity Type | Organization
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Legal Business Name | WOMENS HEALTH PROVIDERS LLC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 330 SALEM WOODSTOWN ROAD SUITE#6
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City | SALEM
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State | NJ
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Zip | 08079
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Country | US
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Telephone | 856-935-1900
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Fax | 856-935-1924
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Provider Business Mailing Address
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Address Line | 330 SALEM WOODSTOWN ROAD SUITE#6
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City | SALEM
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State | NJ
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Zip | 08079
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Country | US
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Telephone | 856-935-1900
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Fax | 856-935-1924
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LUCINDA G. SHAW
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Credential | CNM MSN
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Telephone | 856-935-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 25ME00026801
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License Number State | NJ
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