Provider Demographics
NPI:1417380577
Name:CENTER FOR WOMEN'S HEALTHCARE LLC
Entity Type:Organization
Organization Name:CENTER FOR WOMEN'S HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHIPA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLIMULLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-570-2727
Mailing Address - Street 1:220 HAMBURG TPKE STE 21
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2132
Mailing Address - Country:US
Mailing Address - Phone:973-570-2727
Mailing Address - Fax:800-754-8216
Practice Address - Street 1:220 HAMBURG TPKE STE 21
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2132
Practice Address - Country:US
Practice Address - Phone:973-321-1688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07089000174400000X
207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8327602Medicaid
P2843436OtherOXFORD
P2843436OtherOXFORD