Provider Demographics
NPI:1578883120
Name:WOMEN MIDWIFERY HEALTH CARE SERVICE PC
Entity Type:Organization
Organization Name:WOMEN MIDWIFERY HEALTH CARE SERVICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ENG MEE MOONG
Authorized Official - Middle Name:MARILYN
Authorized Official - Last Name:PAN
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:212-766-9751
Mailing Address - Street 1:48 MARKET ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-8400
Mailing Address - Country:US
Mailing Address - Phone:212-766-9751
Mailing Address - Fax:212-766-1158
Practice Address - Street 1:48 MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-8400
Practice Address - Country:US
Practice Address - Phone:212-766-9751
Practice Address - Fax:212-766-1158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-06
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01944509Medicaid
NY01944509Medicaid