MEDICARE: WOMEN'S CARE NJ PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MA50650	NJ

General Provider Information

NPI Number	:	1366737462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMEN'S CARE NJ PA

Provider Business Mailing Address
First Line	:	36 NEWARK AVE
Second Line	:	SUITE 128
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-4119
Country	:	US
Telephone Number	:	973-751-5454
Fax Number	:	973-751-1717

Provider Business Practice Location Address
First Line	:	36 NEWARK AVE
Second Line	:	SUITE 128
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-4120
Country	:	US
Telephone Number	:	973-751-5454
Fax Number	:	973-751-1717

Authorized Official
Title or Position	:	PRES
Name	:	DR. VIRGINIA IRENE LAY
Credential	:	MD
Telephone Number	:	973-751-5454

Provider Enumeration Date	:	06/16/2011
Last Update Date	:	07/08/2011

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Directions to “WOMEN'S CARE NJ PA ” Practice Location

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