Provider Demographics
NPI:1629244512
Name:SOUTH ORANGE OB/GYN AND INFERTILITY GROUP
Entity Type:Organization
Organization Name:SOUTH ORANGE OB/GYN AND INFERTILITY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDI
Authorized Official - Middle Name:
Authorized Official - Last Name:DRESDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-763-4334
Mailing Address - Street 1:106 VALLEY STREET
Mailing Address - Street 2:2ND FLOOR / RAMP ENTRANCE
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079
Mailing Address - Country:US
Mailing Address - Phone:973-763-4334
Mailing Address - Fax:973-763-4355
Practice Address - Street 1:106 VALLEY STREET
Practice Address - Street 2:2ND FLOOR / RAMP STREET
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079
Practice Address - Country:US
Practice Address - Phone:973-763-4334
Practice Address - Fax:973-763-4355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty