Provider Demographics
NPI:1487744629
Name:SANFORD F WHITE MD OBSTETRICS & GYNECOLOGY LLC
Entity type:Organization
Organization Name:SANFORD F WHITE MD 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:732-698-1115
Mailing Address - Street 1:P.O. BOX 70
Mailing Address - Street 2:THE SOMERSET NETWORK
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07091
Mailing Address - Country:US
Mailing Address - Phone:907-317-6807
Mailing Address - Fax:908-317-6896
Practice Address - Street 1:B4 CORNWALL CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3352
Practice Address - Country:US
Practice Address - Phone:732-698-1115
Practice Address - Fax:732-698-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ601306Medicaid
NJ601306Medicaid