Atlantic Gynecologic On
Obstetrics & Gynecology, Gynecologic Oncology in Wall Township, NJ. Organization (NPI-2).
NPI number1902804693
StatusActive
Last updated in NPPESJan 9, 2008
Details
- NPI
- 1902804693
- Entity type
- Organization (NPI-2)
- Legal business name
- Atlantic Gynecologic On
- Organization subpart
- No
- Enumeration date
- Jul 7, 2005
- Last updated
- Jan 9, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207VX0201X | Obstetrics & Gynecology, Gynecologic Oncology | MB48253 | NJ | Yes |
Practice location
3349 Hwy 138Bldg B Suite F
Wall Township, NJ 07719-9671
Phone 732-280-5464 · Fax 732-280-5443
Mailing address
3349 Hwy 138Bldg B Suite F
Wall Township, NJ 07719-9671
Phone 732-280-5464 · Fax 732-280-5443
Authorized official
Lisa Ann Mendum
Practice Manager
7322805464
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