Healthcare Provider Details

I. General information

NPI: 1255380283
Provider Name (Legal Business Name): OCEAN GYNECOLOGICAL & OBSTETRICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 06/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 ROUTE 70
LAKEWOOD NJ
08701-5897
US

IV. Provider business mailing address

PO BOX 8000 DEPT 797
BUFFALO NY
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 732-364-8000
  • Fax: 732-364-4601
Mailing address:
  • Phone: 866-295-0041
  • Fax: 732-557-7109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT E FABRICANT
Title or Position: DIRECTOR
Credential: MD
Phone: 732-364-8000