Provider Demographics
NPI:1780902775
Name:GREGORY, NAOMI D (DO)
Entity type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:D
Last Name:GREGORY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 EGG HARBOR RD
Mailing Address - Street 2:SUITE B2
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2359
Mailing Address - Country:US
Mailing Address - Phone:856-589-6673
Mailing Address - Fax:856-589-3443
Practice Address - Street 1:570 EGG HARBOR RD
Practice Address - Street 2:SUITE B2
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2359
Practice Address - Country:US
Practice Address - Phone:856-589-6673
Practice Address - Fax:856-589-3443
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015443207Y00000X
NJ25MB09424800207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology