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General NPI Number Information
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NPI Number | 1861697807
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Entity Type | Organization
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Legal Business Name | OBSTETRICAL & GYNECOLOGICAL GROUP OF CENTRAL JERSEY, P.C.
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 1500 SAINT GEORGES AVE SUITE F
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City | AVENEL
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State | NJ
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Zip | 07001-1000
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Country | US
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Telephone | 732-669-9600
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Fax | 732-669-9800
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Provider Business Mailing Address
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Address Line | 1500 SAINT GEORGES AVE SUITE F
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City | AVENEL
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State | NJ
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Zip | 07001-1000
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Country | US
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Telephone | 732-669-9600
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Fax | 732-669-9800
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PHILIP ENGEL KLINE
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Credential | M.D.
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Telephone | 732-669-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA04315300
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License Number State | NJ
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