Healthcare Provider Details

I. General information

NPI: 1225059579
Provider Name (Legal Business Name): PRIMABEL GINA OBIAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINA V OBIAS M.D.

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 11/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CEDAR GROVE LANE SUITE 31
SOMERSET NJ
08873
US

IV. Provider business mailing address

7 CEDAR GROVE LANE SUITE 31
SOMERSET NJ
08873
US

V. Phone/Fax

Practice location:
  • Phone: 732-873-1400
  • Fax: 732-960-3444
Mailing address:
  • Phone: 732-873-1400
  • Fax: 732-960-3444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA67720
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA06772000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: