Individual
DR. MICHAEL ANDREW GISTRAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
865 STONE ST, RAHWAY, NJ 07065-2742
(732) 499-6139
(732) 499-6122
Mailing address
865 STONE ST, RAHWAY, NJ 07065-2742
(732) 499-6139
(732) 499-6122
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207ZP0101X
Anatomic Pathology Physician
25MA06367700
NJ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
25MA06367700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6857108
—
NJ
Enumeration date
05/05/2006
Last updated
11/22/2017
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