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Organization
GERIATRICS AND INTERNAL MEDICINE ASSOCIATES OF NORTHEAST LLC
Active
Organization
GERIATRICS AND INTERNAL MEDICINE ASSOCIATES OF NORTHEAST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANTHI GUNADASA MD, MBBS (OWNER)
(347) 308-4561
Entity
Organization
Contact information
Practice address
1 W RIDGEWOOD AVE, SUITE 203, PARAMUS, NJ 07652-2359
(347) 308-4561
Mailing address
1 W RIDGEWOOD AVE, SUITE 203, PARAMUS, NJ 07652-2359
(347) 308-4561
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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