Individual
JUSTIN GANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
425 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 840-2200
Mailing address
3181 SW SAM JACKSON PARK RD, MAILCODE SJH-2, PORTLAND, OR 97239-3011
(503) 494-4910
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA11491000
NJ
207L00000X
Anesthesiology Physician
296538
NY
207L00000X
Anesthesiology Physician
DO-05777
IA
207L00000X
Anesthesiology Physician
DO206782
OR
Other
Enumeration date
04/14/2015
Last updated
10/12/2022
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