Basic Information
| Provider Information | |||||||||
| NPI: | 1154490175 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTH JERSEY GASTROENTEROLOY AND ENDOSCOPY ASSOCIATES PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1825 ROUTE 23 SOUTH | ||||||||
| Address2: | |||||||||
| City: | WAYNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736331484 | ||||||||
| FaxNumber: | 9736337980 | ||||||||
| Practice Location | |||||||||
| Address1: | 1825 ROUTE 23 SOUTH | ||||||||
| Address2: | FLOOR 2 | ||||||||
| City: | WAYNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736331484 | ||||||||
| FaxNumber: | 9736337980 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2006 | ||||||||
| LastUpdateDate: | 07/09/2014 | ||||||||
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| AuthorizedOfficialLastName: | BLEICHER | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9736331484 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.