=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487979357
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTRAL MORRIS OBSTETRICAL ASSOC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2010
-----------------------------------------------------
Last Update Date | 04/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 WEST BLACKWELL STREET CENTRAL MORRIS OBSTETRICAL ASSOC LLC
-----------------------------------------------------
City | DOVER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-989-3114
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 66 FORD ROAD, SUITE 201 SAINT CLARE'S HOSPITAL
-----------------------------------------------------
City | DENVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07834
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-983-1751
-----------------------------------------------------
Fax | 973-983-1779
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR, BUDGET & REIMBURSEMENT
-----------------------------------------------------
Name | STEPHEN LEVINSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 973-983-1781
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------