Basic Information
| Provider Information | |||||||||
| NPI: | 1134299977 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GILBERTO GASTELL, MD, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 408 37TH ST | ||||||||
| Address2: | |||||||||
| City: | UNION CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070874804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018644477 | ||||||||
| FaxNumber: | 2018649727 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076313574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018169636 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GASTELL | ||||||||
| AuthorizedOfficialFirstName: | GILBERTO | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DELEGATED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 2018644477 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.