Provider Demographics
NPI:1265651889
Name:CPP GYN GROUP CORP.
Entity Type:Organization
Organization Name:CPP GYN GROUP CORP.
Other - Org Name:OB GYN GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:POU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-882-2945
Mailing Address - Street 1:6429 CARR 2 PMB 94
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-6429
Mailing Address - Country:US
Mailing Address - Phone:787-882-2945
Mailing Address - Fax:787-882-2945
Practice Address - Street 1:BUEN SAMARITANO HOSPITAL
Practice Address - Street 2:LEVEL G OFFICE 9
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605
Practice Address - Country:US
Practice Address - Phone:787-882-2945
Practice Address - Fax:787-882-2945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherEIN NUMBER