Provider Demographics
NPI:1609015825
Name:RENEW GYNECOLOGY, L.L.C.
Entity Type:Organization
Organization Name:RENEW GYNECOLOGY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:INGA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZILBERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-750-1482
Mailing Address - Street 1:4 LITCHFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:NJ
Mailing Address - Zip Code:07620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 LITCHFIELD WAY
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:NJ
Practice Address - Zip Code:07620
Practice Address - Country:US
Practice Address - Phone:120-175-0148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO7432400207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA07432400OtherNJ LICENSE