Organization
GEMSTONE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL GARNETT CARRUTH JR. MD (PEDIATRICIAN)
(973) 752-5272
Entity
Organization
Contact information
Practice address
485 PARK AVE, ORANGE, NJ 07050-1721
(973) 672-2770
Mailing address
25 SALTER PL, MAPLEWOOD, NJ 07040-2629
(973) 752-5272
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA07029000
MEDICAL LICENSE
NJ
Enumeration date
04/28/2020
Last updated
11/27/2023
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