Individual
DR. GERALD WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
505 CHESTNUT STREET, ROSELLE PARK, NJ 07204
(908) 241-0200
(908) 241-1615
Mailing address
505 CHESTNUT ST, ROSELLE PARK, NJ 07204-1918
(908) 241-0200
(908) 241-1615
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
22284
NJ
207Y00000X
Otolaryngology Physician
236854
NY
207YS0123X
Facial Plastic Surgery Physician
22284
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0729169013
CIGNA
NJ
01
—
25659
AETNA
NJ
Enumeration date
05/23/2006
Last updated
11/18/2011
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