Provider Demographics
NPI:1891443834
Name:WOMEN'S HEALTH AND GYNECOLOGY OF NEW ENGLAND, PC
Entity Type:Organization
Organization Name:WOMEN'S HEALTH AND GYNECOLOGY OF NEW ENGLAND, PC
Other - Org Name:WOMEN'S HEALTH NEW ENGLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:EDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-947-0800
Mailing Address - Street 1:511 W. GROVE ST.
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346
Mailing Address - Country:US
Mailing Address - Phone:508-947-0800
Mailing Address - Fax:508-947-8133
Practice Address - Street 1:511 W. GROVE ST.
Practice Address - Street 2:SUITE 304
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346
Practice Address - Country:US
Practice Address - Phone:508-947-0800
Practice Address - Fax:508-947-8133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAS2751837OtherDRUG ENFORCEMENT ADMINISTRATION
MA1952751837OtherDEA