Provider Demographics
NPI:1588295604
Name:BROOKLYN WOMENS HEALTH LLC
Entity type:Organization
Organization Name:BROOKLYN WOMENS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-852-5810
Mailing Address - Street 1:421 78TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3447
Mailing Address - Country:US
Mailing Address - Phone:718-852-5810
Mailing Address - Fax:718-802-1223
Practice Address - Street 1:421 78TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3447
Practice Address - Country:US
Practice Address - Phone:718-852-5810
Practice Address - Fax:718-802-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty