Provider Demographics
NPI:1447587159
Name:HACKENSACK HEIGHTS OB-GYN PC
Entity Type:Organization
Organization Name:HACKENSACK HEIGHTS OB-GYN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLLADO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-342-1191
Mailing Address - Street 1:150 OVERLOOK AVE
Mailing Address - Street 2:OFFICE # 1
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2206
Mailing Address - Country:US
Mailing Address - Phone:201-342-1181
Mailing Address - Fax:
Practice Address - Street 1:150 OVERLOOK AVE
Practice Address - Street 2:OFFICE # 1
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2206
Practice Address - Country:US
Practice Address - Phone:201-342-1181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05249900207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty