Provider Demographics
NPI:1942421094
Name:WOMEN'S HEALTH ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:WOMEN'S HEALTH ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-798-0500
Mailing Address - Street 1:170 MOUNT PLEASANT RD STE 203
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1476
Mailing Address - Country:US
Mailing Address - Phone:203-798-0500
Mailing Address - Fax:203-798-0881
Practice Address - Street 1:170 MOUNT PLEASANT RD STE 203
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1476
Practice Address - Country:US
Practice Address - Phone:203-798-0500
Practice Address - Fax:203-798-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004396017Medicaid
CTC01225Medicare ID - Type Unspecified