Healthcare Provider Details

I. General information

NPI: 1003036815
Provider Name (Legal Business Name): ENGLEWOOD OB GYN ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 GRAND AVE SUITE 202
ENGLEWOOD NJ
07631-4154
US

IV. Provider business mailing address

370 GRAND AVE SUITE 202
ENGLEWOOD NJ
07631-4154
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-9599
  • Fax: 201-894-9192
Mailing address:
  • Phone: 201-894-9599
  • Fax: 201-894-9192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTHUR H. GROSS
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 201-894-9599