Phoenix OB GYN Associates, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

PHOENIX OB GYN ASSOCIATES, LLC

Practice address

120 Madison Ave
Suite B
Mount Holly, NJ 08060-2055

Phone

(609) 261-4925

Fax

(609) 261-9362

NPI assigned

Jun 23, 2006

Organization subpart

No

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

Authorized official

Name

Richard Teddy Levine, M.D.

Title

Manager

Phone

(609) 261-6701

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699701722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MADISON AVE",
            "address_2": "SUITE B",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602055",
            "telephone_number": "609-261-4925",
            "fax_number": "609-261-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MADISON AVE",
            "address_2": "SUITE B",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602055",
            "telephone_number": "609-261-4925",
            "fax_number": "609-261-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX OB GYN ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "TEDDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "609-261-6701",
        "authorized_official_credential": "M.D."
    },
    "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": "AMERIHEALTH HMO",
            "identifier": "0135505000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Personalized Independent Living Opporuntities & Training Services
• Personalized Independent Living Opporuntities & Training Services
• Brenda Lee Peterkin
• Samara Peters, DO
• Anne Pfarrer-Dazen, DMD
• Phoenix Treatment Center LLC
• Physician Interpretations of New Jersey
• Brunilda Plaku, CRNA
• Marian Polius-McLean, CRNA
• Melanie Polizzi, RN

• Obstetrics & Gynecology Physician in Mount Holly, NJ
• Providers in Mount Holly, 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 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.