Provider Demographics
NPI:1114206851
Name:S.A.S. OBGYN LLC
Entity Type:Organization
Organization Name:S.A.S. OBGYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OWOBAMISHOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHONOWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-203-3520
Mailing Address - Street 1:565 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-2162
Mailing Address - Country:US
Mailing Address - Phone:848-203-3520
Mailing Address - Fax:848-203-3627
Practice Address - Street 1:565 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-2162
Practice Address - Country:US
Practice Address - Phone:848-203-3520
Practice Address - Fax:848-203-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07930600207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty