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General NPI Number Information
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NPI Number | 1134206253
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Entity Type | Organization
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Legal Business Name | BACK, SEIGEL & GOLDSTEIN, MD , PA
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 501 IRON BRIDGE RD SUITE 4
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-431-1807
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Fax | 732-409-2777
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Provider Business Mailing Address
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Address Line | 501 IRON BRIDGE RD SUITE 4
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-431-1807
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Fax | 732-409-2777
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | MRS. PATTI E STEIN
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Credential |
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Telephone | 732-431-1807
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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 |
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License Number State |
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