Organization
PHILADELPHIA WOMEN'S CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA LAZARUS (CREDENTIALING COORDINATOR)
(856) 356-4001
Entity
Organization
Contact information
Practice address
777 APPLETREE ST, 7TH FLOOR, PHILADELPHIA, PA 19106-1526
(215) 574-3590
(856) 356-4038
Mailing address
601 CHAPEL AVE E, CHERRY HILL, NJ 08034-1454
(856) 356-4000
(856) 356-4038
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
109639
PA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
00178701
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0085789
AETNA
—
01
—
0637657000
INDEPENDENT BLUE CROSS
—
05
—
101798790 0002
—
PA
Enumeration date
05/23/2006
Last updated
11/25/2016
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