Provider Demographics
NPI:1043671274
Name:ESSEX COUNTY OB/GYN ASSOCIATES
Entity Type:Organization
Organization Name:ESSEX COUNTY OB/GYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLF FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-927-4800
Mailing Address - Street 1:83 HERRICK ST
Mailing Address - Street 2:SUITE 2004
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2757
Mailing Address - Country:US
Mailing Address - Phone:978-927-4800
Mailing Address - Fax:978-232-5777
Practice Address - Street 1:83 HERRICK ST
Practice Address - Street 2:SUITE 2004
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2757
Practice Address - Country:US
Practice Address - Phone:978-927-4800
Practice Address - Fax:978-232-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty