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General NPI Number Information
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NPI Number | 1861587321
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Entity Type | Organization
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Legal Business Name | CORTLAND OBGYN ASSOCIATES INC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 GARFIELD DR SUITE A
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City | WARREN
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State | OH
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Zip | 44483
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Country | US
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Telephone | 330-372-1828
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Fax | 330-372-2659
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Provider Business Mailing Address
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Address Line | 200 GARFIELD DR NE SUITE A
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City | WARREN
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State | OH
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Zip | 44483-5557
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Country | US
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Telephone | 330-372-1828
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Fax | 330-372-2659
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMINE RUSTOM ABDUL-AAL
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Credential | M.D.
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Telephone | 330-372-1828
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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 | 35-06-8800-A
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License Number State | OH
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