Organization
GERLING INSTITUTE NJ PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY M LEGG (CREDENTIALING)
(347) 584-8903
Entity
Organization
Contact information
Practice address
1117 US HIGHWAY 46 STE 201, CLIFTON, NJ 07013-2450
(212) 882-1110
(212) 882-1120
Mailing address
1117 US HIGHWAY 46 STE 201, CLIFTON, NJ 07013-2450
(212) 882-1110
(212) 882-1120
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376647891
INDIVIDUAL NPI NUMBER
NY
01
—
25MA08958600
STATE LICENSE NUMBER
NJ
Enumeration date
04/21/2020
Last updated
04/21/2020
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