Provider Demographics
NPI:1215009196
Name:GYN-OB ASSOCIATES INC
Entity type:Organization
Organization Name:GYN-OB ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOUSTAFA
Authorized Official - Middle Name:M F
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-679-0911
Mailing Address - Street 1:373 NEW BOSTON RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5814
Mailing Address - Country:US
Mailing Address - Phone:508-679-0911
Mailing Address - Fax:508-536-0310
Practice Address - Street 1:373 NEW BOSTON RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5814
Practice Address - Country:US
Practice Address - Phone:508-679-0911
Practice Address - Fax:508-536-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5066517OtherNON HMO EATNA US HEALTHCA
2269AOtherNHP RHODE ISLAND
MA9778292Medicaid
951961OtherAETNA US HEALTH CARE
MAM11968OtherBC BS MASS
RI0000004325OtherBC BS RHODE ISLAND
0010239OtherNHP MASS
601291OtherTUFTS
RI0000004325OtherBC BS RHODE ISLAND