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General NPI Number Information
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NPI Number | 1477790491
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Entity Type | Organization
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Legal Business Name | WAYNE OBSTETRICS & GYNECOLOGY ASSOCIATES P C
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 510 HAMBURG TPKE SUITE 202
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City | WAYNE
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State | NJ
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Zip | 07470-2025
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Country | US
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Telephone | 973-942-3500
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Fax | 973-942-3881
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Provider Business Mailing Address
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Address Line | 510 HAMBURG TPKE SUITE 202
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City | WAYNE
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State | NJ
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Zip | 07470-2025
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Country | US
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Telephone | 973-942-3500
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Fax | 973-942-3881
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | FARUZA GOF
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Credential |
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Telephone | 973-942-3500
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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 | MA059982
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License Number State | NJ
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