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General NPI Number Information
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NPI Number | 1710013198
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Entity Type | Organization
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Legal Business Name | ATLANTIC CITY GYNECOLOGY GROUP
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1616 PACIFIC AVE SUITE 316
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-6939
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Country | US
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Telephone | 609-344-4554
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Fax | 609-348-2565
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Provider Business Mailing Address
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Address Line | 1616 PACIFIC AVE SUITE 316
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-6939
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Country | US
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Telephone | 609-344-4554
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Fax | 609-348-2565
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALLEN J KLINE
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Credential | D.O.
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Telephone | 60934445554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 10161 A
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License Number State | NJ
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