Provider Demographics
NPI:1720249139
Name:HARMONY HEALTHCARE FOR WOMEN LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:HARMONY HEALTHCARE FOR WOMEN LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-232-0050
Mailing Address - Street 1:PO BOX 8210
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-8210
Mailing Address - Country:US
Mailing Address - Phone:856-232-0050
Mailing Address - Fax:856-232-0251
Practice Address - Street 1:100 KINGS WAY E
Practice Address - Street 2:WASHINGTON PAVILIONS, STE. D4
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2237
Practice Address - Country:US
Practice Address - Phone:856-232-0050
Practice Address - Fax:856-232-0251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB04130200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2330202Medicaid