Provider Demographics
NPI:1194045021
Name:CAPITAL HEALTH WOMENS HEALTH CENTER
Entity Type:Organization
Organization Name:CAPITAL HEALTH WOMENS HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP AMBULATORY SERVICES DIVISION
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-278-5438
Mailing Address - Street 1:PO BOX 8500-8482
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1401 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3835
Practice Address - Country:US
Practice Address - Phone:609-588-5059
Practice Address - Fax:609-528-8868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0235059Medicaid
NJ188646Medicare PIN