Provider Demographics
NPI:1568734739
Name:ASSOCIATES IN OBSTETRICS GYNECOLOGY AND INFERTILITY LLC
Entity Type:Organization
Organization Name:ASSOCIATES IN OBSTETRICS GYNECOLOGY AND INFERTILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-731-7707
Mailing Address - Street 1:375 MOUNT PLEASANT AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2724
Mailing Address - Country:US
Mailing Address - Phone:973-731-7707
Mailing Address - Fax:973-669-0277
Practice Address - Street 1:375 MOUNT PLEASANT AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2724
Practice Address - Country:US
Practice Address - Phone:973-731-7707
Practice Address - Fax:973-669-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05030300207V00000X
NJ25MA05215600207V00000X
NJ25MA05472200207V00000X
NJ25MA08601100207V00000X
NJ25MA06563400207V00000X
NJ25MA05645300207V00000X
NJ25MA02516200207VG0400X
NJ25MA03422800207VG0400X
NJ26NJ00109500363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
134434Medicare PIN