Provider Demographics
NPI:1134284474
Name:PREFERRED WOMENS OBGYN CARE, PC
Entity Type:Organization
Organization Name:PREFERRED WOMENS OBGYN CARE, PC
Other - Org Name:CARE PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:WESTERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-751-9700
Mailing Address - Street 1:2500 RTE 347
Mailing Address - Street 2:BUILDING 19C
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790
Mailing Address - Country:US
Mailing Address - Phone:631-751-9700
Mailing Address - Fax:631-751-6979
Practice Address - Street 1:2500 RTE 347
Practice Address - Street 2:BUILDING 19C
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790
Practice Address - Country:US
Practice Address - Phone:631-751-9700
Practice Address - Fax:631-751-6979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157340207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A64675Medicare UPIN
W35381Medicare PIN