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General NPI Number Information
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NPI Number | 1215288386
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Entity Type | Organization
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Legal Business Name | HIGH RISK PREGNANCY CENTER OF NEW JERSEY P.C.
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Dates
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Enumeration Date | 09/28/2012
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 1 AUER CT SUITE A
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5823
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Country | US
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Telephone | 732-390-1020
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Fax | 732-390-8035
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Provider Business Mailing Address
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Address Line | 908 OAK TREE AVE SUITE M
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City | SOUTH PLAINFIELD
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State | NJ
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Zip | 07080-5100
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Country | US
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Telephone | 908-753-5771
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Fax | 908-753-2473
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Authorized Official
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Title or Position | PHYSICIAN DIRECTOR
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Name | DR. AMBALAVANER KRISHNAMOORTHY
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Credential | M.D.
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Telephone | 908-753-5771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA44629
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA53719
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License Number State | NJ
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