NORTHEAST OBGYN SC (NPI# 1508936154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508936154 |
| Entity Type | Organization |
| Organization Name | NORTHEAST OBGYN SC |
| Practice Address |
7040 N Port Washington Rd Suite 400 Glendale WI 53217-3838 |
| Practice Telephone | 4142288888 |
| Practice Fax Number | 4142288390 |
| Mailing Telephone | 4142288888 |
| Mailing Fax Number | 4142288390 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2010-06-01 |
| Authorized Official Name | DR. GARY P FAIT (PRESIDENT) |
| Authorized Official Telephone | 4142288888 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31388400 | 05 |
| Street Address |
7040 N PORT WASHINGTON RD SUITE 400 |
| City | GLENDALE |
| State | WI |
| Zip Code | 53217-3838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821047283 | James Edward Berman | Dermatology | 7040 N Port Washington Rd, Suite 404, Glendale, WI 53217-3885 | 2006-05-10 |
| 1245506971 | Forefront Dermatology, S.c. | Dermatology | 7040 N Port Washington Rd, Suite 404, Glendale, WI 53217 | 2012-03-27 |
| 1891068599 | Petrou-haefs Eyecare, LLC | Clinic/Center | 7040 N Port Washington Rd, Suite 420, Glendale, WI 53217-3885 | 2012-02-12 |
| 1114183126 | Liberty Ann Boucher | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2008-07-30 |
| 1427234723 | Joseph L Gaffney | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2008-01-16 |
| 1972710077 | Daniel C Ross | Student in an Organized Health Care Education/Training Program | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2007-05-17 |
| 1265562631 | Wisconsin Dental Group,s.c. | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2007-03-06 |
| 1003946252 | Wisconsin Dental Group, S.c. | Dentist | 7040 N Port Washington Rd, Glendale, WI 53217-3838 | 2007-03-06 |
| 1346380979 | James Lipinski | Dentist | 7040 N Port Washington Rd, Ste 414, Glendale, WI 53217-3838 | 2007-02-06 |
| 1942380522 | Stephanie Ann Murphy | Dentist | 7040 N Port Washington Rd, 410, Glendale, WI 53217-3838 | 2006-10-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669093357 | Adventist Health Physicians Network | Obstetrics & Gynecology | 1505 Wilson Ter Ste 300, Glendale, CA 91206-4073 | 2020-05-04 |
| 1821542077 | Crisis Pregnancy Centers of Greater Phoenix | Obstetrics & Gynecology | 10555 N 58th Dr, Glendale, AZ 85302-1360 | 2016-08-04 |
| 1093177156 | Kathryn Reise | Obstetrics & Gynecology | 6316 W Union Hills Dr # 100, Glendale, AZ 85308-1001 | 2016-03-27 |
| 1215324439 | Katherine Elizabeth Roberts | Obstetrics & Gynecology | 4655 N Port Washington Rd Ste 100, Glendale, WI 53212-1070 | 2015-04-26 |
| 1871890160 | Sahag A Arslanian Md, A Medical Corporation | Obstetrics & Gynecology | 1241 S Glendale Ave Ste 201, Glendale, CA 91205-3388 | 2011-02-22 |
| 1689802530 | Chand Jasen Aryasingha | Obstetrics & Gynecology | 3120 Kingridge Way, Glendale, CA 91206-1027 | 2009-06-30 |
| 1073703443 | Kelly Ann Goad | Obstetrics & Gynecology | 5601 W Eugie Ave Ste 100, Glendale, AZ 85304-1256 | 2007-07-31 |
| 1720278666 | Michael Conrad Bryan | Obstetrics & Gynecology | 5310 W Thunderbird Rd Ste 308, Glendale, AZ 85306-4710 | 2007-07-26 |
| 1972793933 | Melissa Gioia Austin I | Obstetrics & Gynecology | 6316 W Union Hills Dr Ste 100, Glendale, AZ 85308-1001 | 2007-07-26 |
| 1134330673 | Sher Institute for Reproductive Medicine Los Angeles Medical Group Inc | Obstetrics & Gynecology | 1520 E Chevy Chase Dr, Suite 101, Glendale, CA 91206-4106 | 2007-05-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.