Provider Demographics
NPI:1407957541
Name:WHITE PLAINS GYNECOLOGY, LLC
Entity Type:Organization
Organization Name:WHITE PLAINS GYNECOLOGY, LLC
Other - Org Name:RYE OBSTETRICS AND GYNECOLOGY, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN-CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-937-6085
Mailing Address - Street 1:12 GREENRIDGE AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1238
Mailing Address - Country:US
Mailing Address - Phone:914-937-6085
Mailing Address - Fax:914-934-3253
Practice Address - Street 1:12 GREENRIDGE AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1238
Practice Address - Country:US
Practice Address - Phone:914-937-6085
Practice Address - Fax:914-934-3253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236004207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEZ421Medicare ID - Type UnspecifiedMEDICARE
NY782D2Medicare UPIN