Organization
GYNECOLOGY AND INTEGRATIVE WOMEN'S CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE MCCLELLAN MD (DIRECTOR)
(949) 933-6827
Entity
Organization
Contact information
Practice address
30 E 23RD ST FL 7, NEW YORK, NY 10010-4440
(847) 606-9678
(212) 202-6005
Mailing address
114 E 25TH ST, NEW YORK, NY 10010-2914
(847) 606-9678
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04026880
—
NY
01
—
1679523914
NPI-1
—
01
—
1760870869
NPI-1
—
Enumeration date
01/29/2019
Last updated
01/29/2019
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