WILLIAMSBURG OB GYN PC


Address: 6620 Fresh Pond Rd, Ridgewood, NY 11385-3314
Phone: 7183812240

WILLIAMSBURG OB GYN PC (NPI# 1932334372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932334372
Entity Type Organization
Organization Name WILLIAMSBURG OB GYN PC
Practice Address 6620 Fresh Pond Rd
Ridgewood
NY 11385-3314
Mailing Address 1619 3rd Ave Apt 7b
New York
NY 10128-3461
Practice Telephone 7183812240
Mailing Telephone 2124274111
Enumeration Date 2009-05-28
Last Update Date 2009-05-28
Authorized Official Name DR. STEPHANIE L GORDIENKO (ATTENDING)
Authorized Official Telephone 2124274111
Authorized Official Credential M.D
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
235252 NY Ambulatory Health Care Facilities

Office Location

Street Address 6620 FRESH POND RD
City RIDGEWOOD
State NY
Zip Code 11385-3314

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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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1346219813 Ridgewood Ambulatory Surgery Center Clinic/Center 1200 E Ridgewood Ave, Ridgewood, NJ 07450-3957 2006-03-16

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Competitor

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City RIDGEWOOD
Zip Code 11385

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Dataset Information

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.

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