Provider Demographics
NPI:1982743902
Name:ALPHA UNIVERSITY OBSTETRICS & GYNECOLOGY LLC
Entity Type:Organization
Organization Name:ALPHA UNIVERSITY OBSTETRICS & GYNECOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:F
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-828-2600
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:THE SOMERSET NETWORK
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07091-0070
Mailing Address - Country:US
Mailing Address - Phone:908-317-6807
Mailing Address - Fax:908-317-6896
Practice Address - Street 1:516 EASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-2038
Practice Address - Country:US
Practice Address - Phone:732-828-2600
Practice Address - Fax:732-828-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX ID#