Provider Demographics
NPI:1033447974
Name:ORCHID GYNECOLOGY PRACTICE, P.C.
Entity Type:Organization
Organization Name:ORCHID GYNECOLOGY PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-935-9393
Mailing Address - Street 1:10 COLUMBIA PLACE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:718-935-9393
Mailing Address - Fax:
Practice Address - Street 1:10 COLUMBIA PL
Practice Address - Street 2:STORE #8
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4525
Practice Address - Country:US
Practice Address - Phone:718-935-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162139207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty