Organization
COMMUNITY GASTROETEROLOGY, PA
Active
Organization
COMMUNITY GASTROETEROLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAKRAPANI PRAKASH M.D. (SOLE PROPRIETOR)
(732) 505-4420
Entity
Organization
Contact information
Practice address
9 HOSPITAL DR STE 15A, TOMS RIVER, NJ 08755-6425
(732) 505-4420
Mailing address
9 HOSPITAL DR STE 15A, TOMS RIVER, NJ 08755-6425
(732) 505-4420
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MA052242
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0349801
—
NJ
Enumeration date
02/09/2007
Last updated
08/22/2020
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