Provider Demographics
NPI:1265533905
Name:WOMEN'S INTERNATIONAL SUPPORT ENVIRONMENT
Entity type:Organization
Organization Name:WOMEN'S INTERNATIONAL SUPPORT ENVIRONMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:ROONEY
Authorized Official - Suffix:
Authorized Official - Credentials:CMF,COF
Authorized Official - Phone:732-257-6611
Mailing Address - Street 1:620 CRANBURY RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4098
Mailing Address - Country:US
Mailing Address - Phone:732-257-6611
Mailing Address - Fax:732-257-2006
Practice Address - Street 1:620 CRANBURY RD
Practice Address - Street 2:SUITE 211
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4098
Practice Address - Country:US
Practice Address - Phone:732-257-6611
Practice Address - Fax:732-257-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8875OtherACS HEALTHNET
NJ6112005Medicaid
216341OtherAARP
510715OtherAETNA
G55492OtherEMPIRE HEALTH CHOICE
A464122OtherOXFORD HEALTHPLANS
NJ0486120001Medicare ID - Type Unspecified