Provider Demographics
NPI:1891170726
Name:PELHAM BAY MEDICAL CARE FOR WOMEN PC
Entity type:Organization
Organization Name:PELHAM BAY MEDICAL CARE FOR WOMEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LAFONTANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-231-7900
Mailing Address - Street 1:3250 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4500
Mailing Address - Country:US
Mailing Address - Phone:718-231-7900
Mailing Address - Fax:718-684-5298
Practice Address - Street 1:3250 WESTCHESTER AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4500
Practice Address - Country:US
Practice Address - Phone:718-231-7900
Practice Address - Fax:718-684-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty