Provider Demographics
NPI:1144368440
Name:WARREN OB-GYN ASSOCIATES
Entity type:Organization
Organization Name:WARREN OB-GYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACOG
Authorized Official - Phone:908-859-5308
Mailing Address - Street 1:985 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1778
Mailing Address - Country:US
Mailing Address - Phone:908-859-5308
Mailing Address - Fax:
Practice Address - Street 1:985 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1778
Practice Address - Country:US
Practice Address - Phone:908-859-5308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA67679174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD07452800OtherCDS BNDD
NJ7715609Medicaid
NJBO6012190OtherFEDERAL DEA REG NUMBER
NJG75094Medicare UPIN
NJBO6012190OtherFEDERAL DEA REG NUMBER