Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

OB GYN PA

Organization Obstetrics & Gynecology Physician · NPI 1336212802

OB GYN PA is an Obstetrics & Gynecology Physician in Hackensack, New Jersey. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

20 Prospect Ave Ste 607
Hackensack, NJ 07601
Phone: (201) 487-3464
Fax: (201) 487-0232
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X

Record details

NPI number1336212802
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cynthia Chettum — Office Manager · (201) 487-3464
NPI enumeratedNovember 15, 2006
Last updated in NPPESApril 17, 2008
Mailing address20 Prospect Avenue, Suite 607, Hackensack, NJ 07601

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