Provider Demographics
NPI:1477853117
Name:WOMEN'S PELVIC HEALTH & WELLNESS
Entity Type:Organization
Organization Name:WOMEN'S PELVIC HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGHSOUDLOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-773-2039
Mailing Address - Street 1:PO BOX 6754
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10150-6754
Mailing Address - Country:US
Mailing Address - Phone:973-773-2039
Mailing Address - Fax:
Practice Address - Street 1:400 E 56TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4147
Practice Address - Country:US
Practice Address - Phone:800-604-3038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty