Provider Demographics
NPI:1295807659
Name:WOMENS GROUP FOR OBSTETRICS AND GYNECOLOGY, PA
Entity type:Organization
Organization Name:WOMENS GROUP FOR OBSTETRICS AND GYNECOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-770-9300
Mailing Address - Street 1:2301 E EVESHAM RD
Mailing Address - Street 2:BUILDING 800, SUITE 122
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4501
Mailing Address - Country:US
Mailing Address - Phone:856-770-9300
Mailing Address - Fax:856-770-9518
Practice Address - Street 1:2301 EVESHAM ROAD
Practice Address - Street 2:BUILDING 800 STE 122
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-770-9300
Practice Address - Fax:856-770-9518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ831677Medicare PIN