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General NPI Number Information
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NPI Number | 1831278282
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Entity Type | Organization
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Legal Business Name | WOMEN AND CHILDREN PRIMARY CARE OF PASSAIC
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 61 PASSAIC AVE
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City | PASSAIC
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State | NJ
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Zip | 07055-4801
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Country | US
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Telephone | 973-473-5053
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Fax | 973-574-9430
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Provider Business Mailing Address
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Address Line | 61 PASSAIC AVE
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City | PASSAIC
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State | NJ
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Zip | 07055-4801
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Country | US
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Telephone | 973-473-5053
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Fax | 973-574-9430
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARILYN CRESPO
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Credential |
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Telephone | 973-473-5053
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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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