Healthcare Provider Details

I. General information

NPI: 1982743902
Provider Name (Legal Business Name): ALPHA UNIVERSITY OBSTETRICS & GYNECOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 02/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 EASTON AVE
SOMERSET NJ
08873-2038
US

IV. Provider business mailing address

PO BOX 70 THE SOMERSET NETWORK
WESTFIELD NJ
07091-0070
US

V. Phone/Fax

Practice location:
  • Phone: 732-828-2600
  • Fax: 732-828-3889
Mailing address:
  • Phone: 908-317-6807
  • Fax: 908-317-6896

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. SANFORD F WHITE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 732-828-2600