Provider Demographics
NPI:1164737706
Name:LIFE CYCLES OBGYN LLC
Entity Type:Organization
Organization Name:LIFE CYCLES OBGYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YAEL
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:ANTEBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-902-1129
Mailing Address - Street 1:3 DOROTHY AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2003
Mailing Address - Country:US
Mailing Address - Phone:917-902-1129
Mailing Address - Fax:
Practice Address - Street 1:3 DOROTHY AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2003
Practice Address - Country:US
Practice Address - Phone:917-902-1129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08600100207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty