Provider Demographics
NPI:1659478915
Name:WOMEN PHYSICIANS OBGYN ASSOCIATES
Entity type:Organization
Organization Name:WOMEN PHYSICIANS OBGYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:TASSIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-569-5151
Mailing Address - Street 1:473 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2918
Mailing Address - Country:US
Mailing Address - Phone:201-569-5151
Mailing Address - Fax:201-569-9193
Practice Address - Street 1:473 SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2918
Practice Address - Country:US
Practice Address - Phone:201-569-5151
Practice Address - Fax:201-569-9193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ555338Medicare ID - Type Unspecified