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General NPI Number Information
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NPI Number | 1184783144
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Entity Type | Organization
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Legal Business Name | OBSTETRICAL & GYNECOLOGICAL GROUP OF EAST BRUNSWICK PA
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 172 SUMMERHILL RD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4911
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Country | US
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Telephone | 732-254-1500
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Fax | 732-254-1436
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Provider Business Mailing Address
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Address Line | 172 SUMMERHILL RD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4911
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Country | US
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Telephone | 732-254-1500
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Fax | 732-254-1878
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JEANNE BRENNAN
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Credential |
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Telephone | 732-254-1500
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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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