Provider Demographics
NPI:1558993964
Name:INTUITIVE WOMENS HEALTH
Entity Type:Organization
Organization Name:INTUITIVE WOMENS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:REZVINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-788-8158
Mailing Address - Street 1:803 NEW RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-1846
Mailing Address - Country:US
Mailing Address - Phone:609-788-8158
Mailing Address - Fax:
Practice Address - Street 1:803 NEW RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-1846
Practice Address - Country:US
Practice Address - Phone:609-788-8158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0112623Medicaid