Basic Information
| Provider Information | |||||||||
| NPI: | 1376670661 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOMEN FOR WOMEN OBSTETRICS & GYNECOLOGY,LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HOLLOW LN STE 315 | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110421215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164374300 | ||||||||
| FaxNumber: | 5164372033 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 HOLLOW LN STE 315 | ||||||||
| Address2: | |||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110421215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164374300 | ||||||||
| FaxNumber: | 5164372033 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2007 | ||||||||
| LastUpdateDate: | 08/25/2022 | ||||||||
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| AuthorizedOfficialLastName: | KARAMBASIS | ||||||||
| AuthorizedOfficialFirstName: | SEVA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5164374300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 175128 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | DB4426 | 01 | NY | MEDICARE RAILROAD | OTHER |