Ob Gyn PA
NPI #1336212802 in Hackensack, New Jersey
Provider Information
- NPI Number
- 1336212802
- Entity Type
- Organization
- Organization Name
- Ob Gyn PA
- Primary Specialty
- Obstetrics & Gynecology
- Enumeration Date
- Nov 15, 2006
- Last Updated
- Apr 17, 2008
Practice Location
- Address
- 20 PROSPECT AVENUE
- Address 2
- SUITE 607
- City
- Hackensack
- State
- New Jersey
- ZIP Code
- 07601
- Phone
- (201) 487-3464
Authorized Official
- Name
- CYNTHIA E CHETTUM
- Title
- OFFICE MANAGER
- Phone
- (201) 487-3464
Specialties & Taxonomy Codes
| Specialty |
|---|
| Obstetrics & Gynecology |
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