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General NPI Number Information
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NPI Number | 1043647829
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Entity Type | Organization
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Legal Business Name | JERSEY CARE OB/GYN LLC
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Dates
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Enumeration Date | 10/10/2013
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 74 ROUTE 9 SUITE 4
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City | ENGLISHTOWN
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State | NJ
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Zip | 07726-9209
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Country | US
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Telephone | 732-254-8900
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Fax | 732-254-8902
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Provider Business Mailing Address
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Address Line | 74 ROUTE 9 SUITE 4
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City | ENGLISHTOWN
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State | NJ
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Zip | 07726-9209
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Country | US
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Telephone | 732-254-8900
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Fax | 732-254-8902
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TATYANA ANDREWS
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Credential | M.D.
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Telephone | 732-254-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA08547200
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License Number State | NJ
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