Provider Demographics
NPI:1376890111
Name:TOTAL WOMEN OBGYN CARE, PC
Entity Type:Organization
Organization Name:TOTAL WOMEN OBGYN CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-309-7933
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-0229
Mailing Address - Country:US
Mailing Address - Phone:917-226-6215
Mailing Address - Fax:516-350-9641
Practice Address - Street 1:24108 140TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-2022
Practice Address - Country:US
Practice Address - Phone:718-949-0146
Practice Address - Fax:718-949-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-11
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235649207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1407965429OtherNPI
1457398620OtherNPI
1407965429OtherNPI
H69657Medicare UPIN