Organization
GASTROENTEROLOGY ASSOCIATES OF NEW JERSEY, LLC
Active
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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