OB GYN PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

OB GYN PA

Practice address

20 Prospect Avenue
Suite 607
Hackensack, NJ 07601

Phone

(201) 487-3464

Fax

(201) 487-0232

NPI assigned

Nov 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cynthia E Chettum

Title

Office Manager

Phone

(201) 487-3464

Specialties & licenses 1

Addresses

Other identifiers 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1336212802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVENUE",
            "address_2": "SUITE 607",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-487-3464",
            "fax_number": "201-487-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVENUE",
            "address_2": "SUITE 607",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-487-3464",
            "fax_number": "201-487-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB GYN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "CHETTUM",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-487-3464"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MDCR GROUP #",
            "identifier": "CF1821",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO GROUP #",
            "identifier": "0511943",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO GROUP #",
            "identifier": "8750176",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa M O'Donnell, M.D.
• Tara Renee O'Donnell, PA-C
• Kathleen Patricia O'Hara, M.D.
• Natalie Regina O'Leary, APN
• Margaret A O'Neill, MSW, LCSW
• Iseri F. Obadaseraye, MD
• Victoria Obelle
• OBGYN Associates of North Jersey
• Nneka Obi, DDS
• Amanda Ocampo, PA-C

• Obstetrics & Gynecology Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.