Provider Demographics
NPI:1518976596
Name:WOMEN'S PHYSICIANS & SURGEONS, PA
Entity Type:Organization
Organization Name:WOMEN'S PHYSICIANS & SURGEONS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-303-1014
Mailing Address - Street 1:245 A MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747
Mailing Address - Country:US
Mailing Address - Phone:732-566-4264
Mailing Address - Fax:732-566-1280
Practice Address - Street 1:501 IRONBRIDGE RD
Practice Address - Street 2:SUITE 10
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-431-2999
Practice Address - Fax:732-431-2993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2790301Medicaid
NJ526400Medicare ID - Type Unspecified