Basic Information
| Provider Information | |||||||||
| NPI: | 1295747095 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOROCH | ||||||||
| FirstName: | ROMAN | ||||||||
| MiddleName: | STEPHAN OREST | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 408 RIDGEWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | GLEN RIDGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070281618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737445604 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 E 233RD ST | ||||||||
| Address2: | DEPARTMENT OF OBSTETRICS AND GYNECOLOGY | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104662604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189209648 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 192333 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.