Provider Demographics
NPI:1265156764
Name:NORTH JERSEY GYNECOLOGY ASSOCIATES LLC
Entity type:Organization
Organization Name:NORTH JERSEY GYNECOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GELMAN-NISANOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-290-6070
Mailing Address - Street 1:800 KINDERKAMACK RD STE 204S
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1534
Mailing Address - Country:US
Mailing Address - Phone:201-932-2051
Mailing Address - Fax:
Practice Address - Street 1:800 KINDERKAMACK RD STE 204S
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1534
Practice Address - Country:US
Practice Address - Phone:201-932-2051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty