Provider Demographics
NPI:1164639217
Name:AZU, WILHELMINA (DO)
Entity Type:Individual
Prefix:DR
First Name:WILHELMINA
Middle Name:
Last Name:AZU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 RIVER TER
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-7314
Mailing Address - Country:US
Mailing Address - Phone:732-505-8444
Mailing Address - Fax:
Practice Address - Street 1:222 OAK AVE
Practice Address - Street 2:3RD FL
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3348
Practice Address - Country:US
Practice Address - Phone:732-914-1919
Practice Address - Fax:732-914-0210
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08314300207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology