Provider Demographics
NPI:1043647829
Name:JERSEY CARE OB/GYN LLC
Entity Type:Organization
Organization Name:JERSEY CARE OB/GYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-254-8900
Mailing Address - Street 1:74 ROUTE 9
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-9209
Mailing Address - Country:US
Mailing Address - Phone:732-254-8900
Mailing Address - Fax:732-254-8902
Practice Address - Street 1:74 ROUTE 9
Practice Address - Street 2:SUITE 4
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-9209
Practice Address - Country:US
Practice Address - Phone:732-254-8900
Practice Address - Fax:732-254-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08547200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty