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Organization
TRIUNE OB/GYN SERVICES, LLC
Active
Organization
TRIUNE OB/GYN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE FORD (SOLE PROPRIETER)
(718) 469-3377
Entity
Organization
Contact information
Practice address
1416 BEVERLEY RD, BROOKLYN, NY 11226-4514
(718) 469-3377
Mailing address
975 JEROME ST, BALDWIN, NY 11510-5018
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
195127
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01642204
—
NY
Enumeration date
08/09/2006
Last updated
08/22/2020
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