Organization
GASTROENTEROLOGY GROUP OF SOUTH JERSEY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY MATUSOW DO (OWNER)
(856) 691-1400
Entity
Organization
Contact information
Practice address
602 W SHERMAN AVE, VINELAND, NJ 08360-7054
(856) 691-1400
(856) 691-7117
Mailing address
602 W SHERMAN AVE, VINELAND, NJ 08360-7054
(856) 691-1400
(856) 691-7117
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0185588000
AMERIHEALTH
NJ
01
—
0458453
AETNA
NJ
01
—
1055942
HORIZON NJ HEALTH
NJ
05
—
5430208
—
NJ
01
—
CU000003403
AMERICHOICE
NJ
Enumeration date
12/13/2006
Last updated
06/11/2008
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