Organization
P.G. MEDICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAO S GOURKANTI M.D. (PRESIDENT)
(732) 741-4668
Entity
Organization
Contact information
Practice address
31 SEVEN BRIDGES RD, LITTLE SILVER, NJ 07739-1634
(732) 741-4668
(732) 219-1681
Mailing address
31 SEVEN BRIDGES RD, LITTLE SILVER, NJ 07739-1634
(732) 741-4668
(732) 219-1681
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA55303
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074047
—
NJ
05
—
4620305
—
NJ
Enumeration date
02/26/2007
Last updated
07/08/2013
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