Provider Demographics
NPI:1346318581
Name:WAYNE OBSTETRICAL GROUP P A
Entity Type:Organization
Organization Name:WAYNE OBSTETRICAL GROUP P A
Other - Org Name:ASSOCIATES IN WOMEN'S HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-831-8066
Mailing Address - Street 1:1777 HAMBURG TPKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5211
Mailing Address - Country:US
Mailing Address - Phone:973-831-1800
Mailing Address - Fax:973-831-8820
Practice Address - Street 1:1777 HAMBURG TPKE
Practice Address - Street 2:SUITE 202
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5211
Practice Address - Country:US
Practice Address - Phone:973-831-1800
Practice Address - Fax:973-831-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ526587Medicare ID - Type Unspecified