Provider Demographics
NPI:1023162385
Name:PROSPECT WOMEN'S HEALTH CENTER, LLC
Entity type:Organization
Organization Name:PROSPECT WOMEN'S HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALEED
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:ABDELGHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-342-7002
Mailing Address - Street 1:77 PROSPECT AVE
Mailing Address - Street 2:SUITE#1B
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1262
Mailing Address - Country:US
Mailing Address - Phone:201-342-7002
Mailing Address - Fax:201-342-7055
Practice Address - Street 1:77 PROSPECT AVE
Practice Address - Street 2:1B
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1913
Practice Address - Country:US
Practice Address - Phone:201-342-7002
Practice Address - Fax:201-342-7055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1270009261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service