Provider Demographics
NPI:1013061381
Name:ALLIANCE OB GYN CONSULTANTS LLC
Entity Type:Organization
Organization Name:ALLIANCE OB GYN CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHIKE
Authorized Official - Middle Name:W
Authorized Official - Last Name:OBIANWU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACOG, MBA
Authorized Official - Phone:856-764-7660
Mailing Address - Street 1:5045 ROUTE 130
Mailing Address - Street 2:SUITE I
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-9707
Mailing Address - Country:US
Mailing Address - Phone:856-764-7660
Mailing Address - Fax:856-764-5723
Practice Address - Street 1:5045 ROUTE 130
Practice Address - Street 2:SUITE I
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-9707
Practice Address - Country:US
Practice Address - Phone:856-764-7660
Practice Address - Fax:856-764-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ026468Medicaid
NJ080275Medicare ID - Type UnspecifiedGROUP ID