1396856456 NPI number — OB GYN ASSOCIATES LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396856456 NPI number — OB GYN ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OB GYN ASSOCIATES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396856456
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6900 PEARL RD.
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
MIDDLEBURG HTS.
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44130-3640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-884-9000
Provider Business Mailing Address Fax Number:
440-884-4929

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6900 PEARL RD.
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
MIDDLEBURG HTS.
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44130-3640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-884-9000
Provider Business Practice Location Address Fax Number:
440-884-4929
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SADIE
Authorized Official First Name:
TINA
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
440-884-9000

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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