Organization
GENESIS ADDICTION AND BEHAVIORAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R. GANON DO (MEDICAL DIRECTOR)
(973) 862-4297
Entity
Organization
Contact information
Practice address
179 HIGH ST STE 101, NEWTON, NJ 07860-1010
(973) 862-4297
(973) 327-7760
Mailing address
179 HIGH ST STE 101, NEWTON, NJ 07860-1010
(973) 862-4297
(973) 327-7760
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
25MB05783900
NJ
Other
Enumeration date
04/20/2018
Last updated
06/28/2023
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