Prospect Women'S Medical Group, P.C.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

25MA05630700 Issued in NJ

Legal business name

PROSPECT WOMEN'S MEDICAL GROUP, P.C.

Practice address

120 Prospect Ave
Hackensack, NJ 07601-2256

Phone

(201) 342-1600

Fax

(201) 342-2280

NPI assigned

Nov 12, 2009

Organization subpart

No

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

Authorized official

Name

Robin H. Levat, MD

Title

President

Phone

(201) 342-1600

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1760719793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012256",
            "telephone_number": "201-342-1600",
            "fax_number": "201-342-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012256",
            "telephone_number": "201-342-1600",
            "fax_number": "201-342-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT WOMEN'S MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "LEVAT",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-342-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA05630700",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NJ",
            "license": "25MA05630700",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA05630700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Progressive Pediatric Endocrine
• Prospect Medical PC
• Prospect Psychiatric Services Limited Liability Company
• Prospect Women'S Health Center, LLC
• Prospect Women'S Medical Center
• Tracy Ann Proverbs-Singh, M.D.
• Aleksandar Prvulovic
• Psychiatric Associates LLP
• Maksim Ptushko, M.D.
• Ajay Kumar Puri, MD

• All providers in Hackensack, NJ
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.