Provider Demographics
NPI:1104945666
Name:ALL WOMEN'S MEDICAL PAVILION P.C.
Entity type:Organization
Organization Name:ALL WOMEN'S MEDICAL PAVILION P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILBAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-793-1943
Mailing Address - Street 1:6930 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4222
Mailing Address - Country:US
Mailing Address - Phone:718-793-1943
Mailing Address - Fax:718-793-1409
Practice Address - Street 1:6930 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4222
Practice Address - Country:US
Practice Address - Phone:718-793-1943
Practice Address - Fax:718-793-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty