Provider Demographics
NPI:1861697807
Name:OBSTETRICAL & GYNECOLOGICAL GROUP OF CENTRAL JERSEY, P.C.
Entity type:Organization
Organization Name:OBSTETRICAL & GYNECOLOGICAL GROUP OF CENTRAL JERSEY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:ENGEL
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-669-9600
Mailing Address - Street 1:1500 SAINT GEORGES AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1000
Mailing Address - Country:US
Mailing Address - Phone:732-669-9600
Mailing Address - Fax:732-669-9800
Practice Address - Street 1:1500 SAINT GEORGES AVE
Practice Address - Street 2:SUITE F
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1000
Practice Address - Country:US
Practice Address - Phone:732-669-9600
Practice Address - Fax:732-669-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04315300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD06147Medicare UPIN
NJ083602Medicare ID - Type UnspecifiedMEDICARE NUMBER