Provider Demographics
NPI:1699833392
Name:OBSTETRICAL & GYNECOLOGICAL GROUP OF METUCHEN, PA
Entity type:Organization
Organization Name:OBSTETRICAL & GYNECOLOGICAL GROUP OF METUCHEN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HORN
Authorized Official - Last Name:AINSLIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:732-548-0698
Mailing Address - Street 1:73 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2549
Mailing Address - Country:US
Mailing Address - Phone:732-548-0698
Mailing Address - Fax:732-548-1260
Practice Address - Street 1:73 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2549
Practice Address - Country:US
Practice Address - Phone:732-548-0698
Practice Address - Fax:732-548-1260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCG2587OtherRR MEDICARE
NJ0801045000OtherAMERIHEALTH
NJ0032148OtherGHI INSURANCE
NJ0801045000OtherAMERIHEALTH