Organization
MID-NJ GYNECOLOGICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE GRIFFIN (CREDENTIALING COORDINATOR)
(856) 356-4025
Entity
Organization
Contact information
Practice address
500 KINGS HWY N, SUITE 100, CHERRY HILL, NJ 08034-1502
(856) 667-5910
Mailing address
601 CHAPEL AVE E, CHERRY HILL, NJ 08034-1454
(856) 356-4000
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1163499
AETNA HMO
NJ
01
—
2313623000
IBC HMO
NJ
Enumeration date
08/18/2006
Last updated
12/18/2013
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