# MODERN WOMAN PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295032068
- **Authorized official:** DR. SHAZAH KHAWAJA (DIRECTOR)
- **Authorized official phone:** (973) 239-8299

## Contact information

- **Practice address:** 550 NEWARK AVE, JERSEY CITY, NJ 07306-1326
- **Practice address phone:** (862) 239-8299
- **Mailing address:** 684 MARKET ST, PATERSON, NJ 07513-1231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/14/2011
- **Last updated:** 02/23/2011