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General NPI Number Information
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NPI Number | 1295249100
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Entity Type | Organization
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Legal Business Name | RIDGEWOODS OBSTETRICS & GYNECOLOGY
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 11/30/2017
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Provider Practice Location Address
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Address Line | 6605 FRESH POND RD
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City | RIDGEWOOD
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State | NY
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Zip | 11385-3334
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Country | US
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Telephone | 917-513-1374
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Fax |
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Provider Business Mailing Address
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Address Line | 6605 FRESH POND RD
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City | RIDGEWOOD
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State | NY
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Zip | 11385-3334
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Country | US
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Telephone | 917-513-1374
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. OSKAR A GAWEDA
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Credential | MD
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Telephone | 917-513-1374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 264565
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License Number State | NY
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