Provider Demographics
NPI:1164562153
Name:ADVANCED WOMENS MEDICAL
Entity Type:Organization
Organization Name:ADVANCED WOMENS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D. F.A.C.O.G.
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VOSKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-279-3300
Mailing Address - Street 1:664 STONELEIGH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3940
Mailing Address - Country:US
Mailing Address - Phone:845-279-3300
Mailing Address - Fax:845-279-5343
Practice Address - Street 1:ADVANCED WOMEN MEDICAL
Practice Address - Street 2:664 STONELEIGH AVE SUITE 201
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3940
Practice Address - Country:US
Practice Address - Phone:845-279-3300
Practice Address - Fax:845-279-5343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty