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Individual

FREDERICK D GANGEMI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
65 NEWARK AVE, BELLEVILLE, NJ 07109-1135
(973) 751-8454
(973) 751-0071
Mailing address
65 NEWARK AVE, BELLEVILLE, NJ 07109-1135
(973) 751-8454
(973) 751-0071

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MA04340200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1472801
NJ
Enumeration date
09/14/2006
Last updated
07/08/2007
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