Provider Demographics
NPI:1588039507
Name:WOMENS HEALTH ALLIANCE OF NJ
Entity Type:Organization
Organization Name:WOMENS HEALTH ALLIANCE OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANU
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAKRABORTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-935-0700
Mailing Address - Street 1:224 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1731
Mailing Address - Country:US
Mailing Address - Phone:732-935-0700
Mailing Address - Fax:
Practice Address - Street 1:224 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1731
Practice Address - Country:US
Practice Address - Phone:732-935-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA065000207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0004189Medicare PIN
NJG81362Medicare UPIN