Provider Demographics
NPI:1992154678
Name:METROPOLITAN OBGYN
Entity type:Organization
Organization Name:METROPOLITAN OBGYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAFFEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-996-2600
Mailing Address - Street 1:1973 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3435
Mailing Address - Country:US
Mailing Address - Phone:973-996-2600
Mailing Address - Fax:973-996-2601
Practice Address - Street 1:1973 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3435
Practice Address - Country:US
Practice Address - Phone:973-996-2600
Practice Address - Fax:973-996-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14879300302R00000X
NJ25NJ00645500302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization