Provider Demographics
NPI:1477856854
Name:BRICKNER MANTELL CENTER FOR WOMEN'S HEALTH, LLC
Entity Type:Organization
Organization Name:BRICKNER MANTELL CENTER FOR WOMEN'S HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRICKNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-689-9991
Mailing Address - Street 1:1A QUAKERBRIDGE PLZ
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1265
Mailing Address - Country:US
Mailing Address - Phone:609-689-9991
Mailing Address - Fax:609-689-9992
Practice Address - Street 1:1A QUAKERBRIDGE PLZ
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1265
Practice Address - Country:US
Practice Address - Phone:609-689-9991
Practice Address - Fax:609-689-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty