Organization
GASTROENTEROLGY CENTER, PA
Active
Organization
GASTROENTEROLGY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR GROISSER MD (OWNER)
(973) 746-5166
Entity
Organization
Contact information
Practice address
21 PLYMOUTH ST, MONTCLAIR, NJ 07042-2607
(973) 746-5166
(973) 746-7922
Mailing address
21 PLYMOUTH ST, MONTCLAIR, NJ 07042-2607
(973) 746-5166
(973) 746-7922
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MA-16509
NJ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
25MA08496100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8029903
—
NY
Enumeration date
01/09/2006
Last updated
06/08/2010
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