Provider Demographics
NPI:1518017870
Name:WOMEN'S MEDICAL CONNECTION, LLC
Entity Type:Organization
Organization Name:WOMEN'S MEDICAL CONNECTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-796-9400
Mailing Address - Street 1:999 PALMER AVE
Mailing Address - Street 2:BUILDING 7
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1087
Mailing Address - Country:US
Mailing Address - Phone:732-796-9400
Mailing Address - Fax:732-796-9414
Practice Address - Street 1:999 PALMER AVE
Practice Address - Street 2:BUILDING 7
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1087
Practice Address - Country:US
Practice Address - Phone:732-796-9400
Practice Address - Fax:732-796-9414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ07881000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ107683Medicare PIN