Organization Active NPI

Jersey Shore Obstetrics and Gynecology

  • Gynecology Physician
  • Freehold, NJ
National Provider Identifier
1386609469
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
JERSEY SHORE OBSTETRICS AND GYNECOLOGY
Practice address
509 Stillwells Corner Rd
Freehold, NJ 07728-2965
Phone
(732) 577-1199
Fax
(732) 577-8922
NPI assigned
Apr 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carl Marchetti, M.D.
Title
Director
Phone
(732) 577-1199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X NJ Primary

Addresses

Primary practice location

509 Stillwells Corner Rd
Freehold, NJ 07728-2965

Mailing address

PO Box 23876
Newark, NJ 07189-0001
Phone (732) 577-1199

National Provider Directory

National Provider Directory

Locations

509 Stillwells Corner Rd
Freehold, NJ 07728
Phone (732) 431-4800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386609469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23876",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071890001",
            "telephone_number": "732-577-1199",
            "fax_number": "732-577-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 STILLWELLS CORNER RD",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282965",
            "telephone_number": "732-577-1199",
            "fax_number": "732-577-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE OBSTETRICS AND GYNECOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARCHETTI",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-577-1199",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.