Provider Demographics
NPI:1588772859
Name:OBSTETRICAL&GNECOLOGICAL GROUP OF PERTH AMBOY EDISON P.A
Entity type:Organization
Organization Name:OBSTETRICAL&GNECOLOGICAL GROUP OF PERTH AMBOY EDISON P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAFAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-826-3600
Mailing Address - Street 1:511 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-3655
Mailing Address - Country:US
Mailing Address - Phone:732-826-3600
Mailing Address - Fax:732-826-3651
Practice Address - Street 1:511 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3655
Practice Address - Country:US
Practice Address - Phone:732-826-3600
Practice Address - Fax:732-826-3651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03281700207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty