Individual
DR. GARY D WASSERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
663 PALISADE AVE STE 304, CLIFFSIDE PARK, NJ 07010-3012
(201) 313-1933
(201) 313-9599
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA05621000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4562801
—
NJ
01
—
4S9831
EMPIRE BCBS# (75 SOUTH DEAN)
NJ
01
—
4S9832
EMPIRE BCBS# (CLIFFSIDE PARK)
NJ
01
—
4S9833
EMPIRE BCBS# (180 N. DEAN)
NJ
01
—
80988
AMERIGROUP#
NJ
01
—
BS350
OXFORD#
NJ
01
—
P00392865
RAILROAD MEDICARE#
NJ
Enumeration date
10/19/2006
Last updated
03/07/2022
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