Individual
GERALD GRODSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
177 N DEAN ST, SUITE 207, ENGLEWOOD, NJ 07631-2533
(201) 567-0446
Mailing address
177 N DEAN ST, SUITE 207, ENGLEWOOD, NJ 07631-2533
(201) 567-0446
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MA03799200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0K3260
HEALTH NET
NJ
01
—
412640
CIGNA
NJ
01
—
BP293
OXFORD HEALTH
NJ
Enumeration date
11/07/2005
Last updated
11/08/2007
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