Provider Demographics
NPI:1760662381
Name:PREMIER OB GYN HEALTHCARE, LLC
Entity Type:Organization
Organization Name:PREMIER OB GYN HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-429-0044
Mailing Address - Street 1:971 ROUTE 202 NORTH
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876
Mailing Address - Country:US
Mailing Address - Phone:908-429-0044
Mailing Address - Fax:908-429-0048
Practice Address - Street 1:971 ROUTE 202 NORTH
Practice Address - Street 2:SUITE 1
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876
Practice Address - Country:US
Practice Address - Phone:908-429-0044
Practice Address - Fax:908-429-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ073472Medicare PIN