Provider Demographics
NPI:1720153976
Name:WOMEN'S TOTAL HEALTH, L.L.C.
Entity Type:Organization
Organization Name:WOMEN'S TOTAL HEALTH, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:M
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-209-1200
Mailing Address - Street 1:3317 ROUTE 94
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-2552
Mailing Address - Country:US
Mailing Address - Phone:973-209-1200
Mailing Address - Fax:973-209-1201
Practice Address - Street 1:3317 ROUTE 94
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-2552
Practice Address - Country:US
Practice Address - Phone:973-209-1200
Practice Address - Fax:973-209-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ052799Medicare PIN
NJ8731101Medicaid