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ATLANTIC GYNECOLOGIC ON
NPI 1902804693
Obstetrics & Gynecology - Gynecologic Oncology in Wall Township, NJ

Active since July 07, 2005
3349 HWY 138, BLDG B SUITE F, WALL TOWNSHIP, NJ 07719(732) 280-5464(732) 280-5443 Get Directions Write a Review

NPPES record last updated: January 9, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Atlantic Gynecologic On NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ATLANTIC GYNECOLOGIC ON (NPI 1902804693) is a healthcare organization registered as a gynecologic oncology in Wall Township, New Jersey and active in the NPI registry since July 2005. The organization lists Lisa Ann Mendum, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1902804693
Entity TypeOrganization
Primary Taxonomy207VX0201X
Legal Business NameATLANTIC GYNECOLOGIC ON
Location Address3349 HWY 138, BLDG B SUITE FWall Township, NJ 07719-9671
Mailing Address3349 Hwy 138, Bldg B Suite FWall Township, NJ 07719-9671 · (732) 280-5464 · Fax (732) 280-5443
Phone(732) 280-5464
Fax(732) 280-5443
Organization SubpartNo
Authorized OfficialLisa Ann MendumPractice Manager · (732) 280-5464
Enumeration DateJuly 7, 2005
Last NPPES UpdateJanuary 9, 2008
✔ NPI 1902804693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207VX0201X
License✔ Licensed in NJ · MB48253
Definition
An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
3349 HWY 138, Wall Township, NJ 07719
Open in Google Maps ↗

Other Identifiers 4

OtherCG6895NJ · Rail Road Medicare
Medicare UPINE55692NJ
Medicare ID-Type Unspecified029655NJ
Medicaid6734502NJ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRICIA WECKENMAN MS CCC-SLP
Speech-Language Pathologist
3349 HWY 138
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-6050
PHYLLIS R PENKETHMAN M.S., CCC-SLP
Speech-Language Pathologist
3349 HWY 138
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-6050
SARAH GOWEN
Speech-Language Pathologist
3349 HWY 138
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-6050
MRS. LESLIE OLD O.T.
Occupational Therapist
3349 HWY 138, BLDG. B. SUTIE A.
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-6050
THOMAS EVERETT HACKETT DO
Obstetrics & Gynecology (Gynecologic Oncology)
3349 HWY 138, BLDG B SUITE F
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-5464
DANIELLE CARLSON
Speech-Language Pathologist
3349 HWY 138
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-6050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Atlantic Gynecologic On's NPI number?

The NPI number for Atlantic Gynecologic On is 1902804693. It was assigned to this organization in the NPPES registry on July 7, 2005.

Where is Atlantic Gynecologic On located?

Atlantic Gynecologic On is located at 3349 Hwy 138 Bldg B Suite F, Wall Township, NJ 07719. The listed phone number is (732) 280-5464.

What is Atlantic Gynecologic On's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

When was this NPI record last updated?

The NPPES record for Atlantic Gynecologic On was last updated on January 9, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.