Provider Demographics
NPI:1225260904
Name:JERSEY GYN ASSOCIATES
Entity Type:Organization
Organization Name:JERSEY GYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOFFARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-686-4334
Mailing Address - Street 1:1323 STUYVESANT AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5380
Mailing Address - Country:US
Mailing Address - Phone:908-686-4334
Mailing Address - Fax:
Practice Address - Street 1:1323 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5380
Practice Address - Country:US
Practice Address - Phone:908-686-4334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty