Provider Demographics
NPI:1376607937
Name:COLTS NECK OBGYN ASSOCIATES, LLC
Entity Type:Organization
Organization Name:COLTS NECK OBGYN ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CIPRIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-431-1616
Mailing Address - Street 1:PO BOX 240
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-0240
Mailing Address - Country:US
Mailing Address - Phone:732-431-1616
Mailing Address - Fax:732-866-7962
Practice Address - Street 1:24 STATE ROUTE 34 S STE D-2
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2415
Practice Address - Country:US
Practice Address - Phone:732-431-1616
Practice Address - Fax:732-866-7962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
50465Medicare ID - Type Unspecified