1851845457 NPI number — BERGEN COUNTY GYNECOLOGY, P.C.

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 1851845457 NPI number — BERGEN COUNTY GYNECOLOGY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BERGEN COUNTY GYNECOLOGY, P.C.
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:
1851845457
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 899
Provider Second Line Business Mailing Address:
SUITE #300
Provider Business Mailing Address City Name:
ALPINE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07620-0899
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-589-1071
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 GRAND AVE
Provider Second Line Business Practice Location Address:
SUITE #300
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07631-3574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-589-1071
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CHO
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
EUN SUN
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
516-589-1071

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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