Provider Demographics
NPI:1114298007
Name:COMPREHENSIVE OBGYN OF CLIFTON PA
Entity Type:Organization
Organization Name:COMPREHENSIVE OBGYN OF CLIFTON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGHSOUDLOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-773-2039
Mailing Address - Street 1:PO BOX 502
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-0502
Mailing Address - Country:US
Mailing Address - Phone:973-773-2039
Mailing Address - Fax:
Practice Address - Street 1:1115 CLIFTON AVE
Practice Address - Street 2:NO 104
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3641
Practice Address - Country:US
Practice Address - Phone:201-531-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty