Provider Demographics
NPI:1609045236
Name:BALTAZAR WOMENS CARE LLC
Entity Type:Organization
Organization Name:BALTAZAR WOMENS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALTAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-449-1979
Mailing Address - Street 1:D71 OMEGA DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-283-3300
Mailing Address - Fax:
Practice Address - Street 1:120 SANDHILL DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19708
Practice Address - Country:US
Practice Address - Phone:302-449-1979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC8364OtherRAILROAD GROUP
DC8364OtherRAILROAD GROUP
G83055Medicare UPIN