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General NPI Number Information
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NPI Number | 1770225393
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Entity Type | Organization
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Legal Business Name | W2W PHYSICIAN SERVICES
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 900 WEST MAIN STREET SUITE 3
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-308-2255
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Fax | 732-394-6432
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Provider Business Mailing Address
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Address Line | 900 WEST MAIN STREET SUITE 3
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-308-2255
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Fax | 732-394-6432
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WAYNE AUTRY
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Credential |
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Telephone | 908-433-2208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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