Provider Demographics
NPI:1275652760
Name:WESTSIDE WOMEN'S MEDICAL PAVILION P.C.
Entity Type:Organization
Organization Name:WESTSIDE WOMEN'S MEDICAL PAVILION P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:T
Authorized Official - Last Name:CONSIDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-946-0050
Mailing Address - Street 1:1841 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7603
Mailing Address - Country:US
Mailing Address - Phone:212-333-5000
Mailing Address - Fax:212-489-7199
Practice Address - Street 1:1841 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:212-333-5000
Practice Address - Fax:212-489-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty