| Organization Name: | JERSEY SHORE WOMEN'S HEALTH, LLC |
| NPI Number: | 1356586671 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIDI SALLOUM (MANAGING MEMBER) |
| Mailing Address: | 1930 Hwy 35 Ste 3 Wall Township |
| State: | NJ US |
| Postal Code: | 077193538 |
| Phone Number: | 7323597060 |
| Fax Number: | 7323597058 |
| NPI Enumeration Date: | 12/16/2008 |
| NPI Last Update Date: | 12/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |