Provider Demographics
NPI:1780417998
Name:HERSPACE WOMENS HEALTH LLC
Entity type:Organization
Organization Name:HERSPACE WOMENS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-571-9100
Mailing Address - Street 1:200 WHITE RD STE 115
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1160
Mailing Address - Country:US
Mailing Address - Phone:732-571-9100
Mailing Address - Fax:732-741-0985
Practice Address - Street 1:200 WHITE RD STE 115
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1160
Practice Address - Country:US
Practice Address - Phone:732-571-9100
Practice Address - Fax:732-741-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty