Provider Demographics
NPI:1790011385
Name:NORTH JERSEY GYNECOLOGY PC
Entity Type:Organization
Organization Name:NORTH JERSEY GYNECOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-236-8282
Mailing Address - Street 1:82 E. ALLENDALE ROAD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458
Mailing Address - Country:US
Mailing Address - Phone:201-236-8282
Mailing Address - Fax:201-236-0138
Practice Address - Street 1:51 ROUTE 23 SOUTH
Practice Address - Street 2:1ST FLOOR
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457
Practice Address - Country:US
Practice Address - Phone:973-831-4200
Practice Address - Fax:201-818-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB06730700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty