Provider Demographics
NPI:1477515740
Name:GYNECOLOGIC CANCER & PELVIC SURGERY LLC
Entity Type:Organization
Organization Name:GYNECOLOGIC CANCER & PELVIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDERS
Authorized Official - Prefix:
Authorized Official - First Name:THAD
Authorized Official - Middle Name:R
Authorized Official - Last Name:DENEHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-243-9300
Mailing Address - Street 1:101 OLD SHORT HILLS RD
Mailing Address - Street 2:STE 400
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1000
Mailing Address - Country:US
Mailing Address - Phone:973-243-9300
Mailing Address - Fax:973-325-8573
Practice Address - Street 1:101 OLD SHORT HILLS RD
Practice Address - Street 2:STE 400
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1000
Practice Address - Country:US
Practice Address - Phone:973-243-9300
Practice Address - Fax:973-325-8573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04766500207VX0201X
NJ207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX ID
NJ=========OtherTAX ID