Provider Demographics
NPI:1629025077
Name:NORTHERN ESSEX WOMEN'S HEALTH, PC
Entity Type:Organization
Organization Name:NORTHERN ESSEX WOMEN'S HEALTH, PC
Other - Org Name:NORTHERN ESSEX OBGYN ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:BYUNGYOL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-556-9060
Mailing Address - Street 1:360 MERRIMACK ST
Mailing Address - Street 2:ENTRANCE G
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1740
Mailing Address - Country:US
Mailing Address - Phone:978-557-9060
Mailing Address - Fax:978-557-9064
Practice Address - Street 1:360 MERRIMACK ST
Practice Address - Street 2:ENTRANCE G
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1740
Practice Address - Country:US
Practice Address - Phone:978-557-9060
Practice Address - Fax:978-557-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
043572001OtherSENIOR WHOLE HEALTH PLAN
9708146OtherMASS HEALTH HEALTHY START
M17811OtherBCBS
043572001OtherCHAMPUS TRICARE
690487OtherTUFTS HEALTH PLAN
DA7668OtherRAILROAD MEDICARE
043572001OtherHEALTH SOURCE
043572001OtherHARVARD PILGRIM
80520OtherFALLON
043572001OtherUNITED HEALTH CARE NE
043572001OtherCIGNA
043572001OtherAETNA
30211826OtherNEW HAMPSHIRE MEDICAID
M20997OtherRAILROAD MEDICARE
0023344OtherNEIGHBORHOOD HEALTH
043572001OtherHEALTH CARE VALUE MGT
DA7668OtherRAILROAD MEDICARE