Organization
CAG MEMORIAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN C. GIBBS JR. M.D. (MEDICAL DIRECTOR)
(201) 333-0094
Entity
Organization
Contact information
Practice address
75 HARRISON AVE, SUITE #2, JERSEY CITY, NJ 07304-2555
(201) 333-0094
(201) 333-6538
Mailing address
75 HARRISON AVE, SUITE #2, JERSEY CITY, NJ 07304-2555
(201) 333-0094
(201) 333-6538
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
MAO13695
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000097700
AMERICHOICE
NJ
05
—
2684403
—
NJ
Enumeration date
08/14/2008
Last updated
08/14/2008
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