Provider Demographics
NPI:1992741581
Name:GYNECOLOGY AND MENOPAUSE CENTER LTD
Entity type:Organization
Organization Name:GYNECOLOGY AND MENOPAUSE CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:FERRONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-725-8787
Mailing Address - Street 1:462 E KING RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3049
Mailing Address - Country:US
Mailing Address - Phone:610-725-8787
Mailing Address - Fax:610-725-9234
Practice Address - Street 1:462 E KING RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3049
Practice Address - Country:US
Practice Address - Phone:610-725-8787
Practice Address - Fax:610-725-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD015643E207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0225034000OtherIBC
3611806OtherAETNA
258476OtherBS
=========OtherUHC
0225034000OtherIBC
C30094Medicare UPIN
0225034000OtherIBC