Individual
DR. GARY D WASSERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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