Provider Demographics
NPI:1225367089
Name:AMERSON WOMEN HEALTH CARE
Entity Type:Organization
Organization Name:AMERSON WOMEN HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AFRIYE
Authorized Official - Middle Name:R
Authorized Official - Last Name:AMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-406-6626
Mailing Address - Street 1:130 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1939
Mailing Address - Country:US
Mailing Address - Phone:917-406-6626
Mailing Address - Fax:
Practice Address - Street 1:130 KINDERKAMACK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1939
Practice Address - Country:US
Practice Address - Phone:917-406-6626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07279100207V00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H44487Medicare UPIN