Provider Demographics
NPI:1093807778
Name:WOMENS HEALTHCARE & AESTHETICS P C
Entity Type:Organization
Organization Name:WOMENS HEALTHCARE & AESTHETICS P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NILES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CHOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-364-1290
Mailing Address - Street 1:400 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4509
Mailing Address - Country:US
Mailing Address - Phone:732-364-1290
Mailing Address - Fax:732-905-8649
Practice Address - Street 1:400 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4509
Practice Address - Country:US
Practice Address - Phone:732-364-1290
Practice Address - Fax:732-905-8649
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMENS HEALTHCARE & AESTHETICS P C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-29
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA065067207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01000618201OtherAMERICHOICE
NJ1K1272OtherHEALTHNET
NJP1281872OtherOXFORD
NJ2118800OtherUS HEALTHCARE
NJ0557065000OtherAMERIHEALTH
NJ7202202Medicaid
NJ03649345OtherCIGNA
NJ022418Medicare ID - Type Unspecified
NJ7202202Medicaid
NJ1K1272OtherHEALTHNET