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Organization

GASTROENTEROLOGY ASSOCIATES OF NEW JERSEY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RACHEL ANDREANO (CREDENTIALING SPECIALIST)
(973) 785-2277
Entity
Organization

Contact information

Practice address
1130 MCBRIDE AVE, WOODLAND PARK, NJ 07424-3806
(973) 812-1400
(973) 812-1404
Mailing address
1130 MCBRIDE AVE, WOODLAND PARK, NJ 07424-3806
(973) 812-1400
(973) 812-1404

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
207RG0100X
Gastroenterology Physician
Primary
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
363AM0700X
Medical Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0175714
NJ
01
1945759
AETNA HMO GROUP NUMBER
NJ
01
3533132000
AMERIHEALTH GROUP NUMBER
NJ
01
9341206
AETNA PPO GROUP NUMBER
NJ
Enumeration date
01/24/2008
Last updated
08/09/2023
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