Provider Demographics
NPI:1154651974
Name:PREMIER OB/GYN GROUP
Entity Type:Organization
Organization Name:PREMIER OB/GYN GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AZER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIZADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-289-5906
Mailing Address - Street 1:1 QUAIL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2165
Mailing Address - Country:US
Mailing Address - Phone:201-289-5906
Mailing Address - Fax:201-289-5908
Practice Address - Street 1:5 SUMMIT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-8503
Practice Address - Country:US
Practice Address - Phone:201-289-5906
Practice Address - Fax:201-289-5908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty