Provider Demographics
NPI:1245412881
Name:ATLANTIC WOMEN'S HEALTHCARE P.C.
Entity type:Organization
Organization Name:ATLANTIC WOMEN'S HEALTHCARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEMASI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-561-7787
Mailing Address - Street 1:653 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2013
Mailing Address - Country:US
Mailing Address - Phone:609-561-7787
Mailing Address - Fax:609-561-7790
Practice Address - Street 1:653 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2013
Practice Address - Country:US
Practice Address - Phone:609-561-7787
Practice Address - Fax:609-561-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05372900207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ090609Medicare PIN
NJF53461Medicare UPIN