Individual
GARY MATUSOW
Active
Individual
GARY MATUSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MB05205400
NJ
207RG0100X
Gastroenterology Physician
Primary
25MB05205400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2345609
—
NJ
Enumeration date
06/19/2006
Last updated
08/21/2023
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