Individual
ERIC GEWOLB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
830 KENNEDY BLVD, BAYONNE, NJ 07002-2872
(201) 339-0200
Mailing address
830 KENNEDY BLVD, BAYONNE, NJ 07002-2872
(201) 339-0200
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA03446400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014315
—
NJ
01
—
222264078
HORIZON BLUESHIELD
NJ
01
—
2264078
OXFORD
NJ
01
—
4412155
PALMETTOGBA
NJ
Enumeration date
05/26/2006
Last updated
07/08/2007
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