Provider Demographics
NPI:1841595675
Name:WOMAN TO WOMAN PROFESSIONAL SERVICES
Entity Type:Organization
Organization Name:WOMAN TO WOMAN PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUTRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-308-2255
Mailing Address - Street 1:900 W MAIN ST STE 240
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2156
Mailing Address - Country:US
Mailing Address - Phone:732-308-2255
Mailing Address - Fax:732-308-0081
Practice Address - Street 1:901 W MAIN ST
Practice Address - Street 2:STE 240 2ND FL
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2537
Practice Address - Country:US
Practice Address - Phone:732-308-2255
Practice Address - Fax:732-308-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ069288207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty