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Individual

GARY E STATMORE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
245 VALLEY BLVD, WOOD-RIDGE, NJ 07075-1236
(201) 438-5500
(201) 438-3363
Mailing address
245 VALLEY BLVD, WOOD-RIDGE, NJ 07075-1236
(201) 438-5500
(201) 438-3363

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MA02277200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0081399000
AMERIHEALTH
NJ
01
0K3970
HEALTHNET
NJ
05
1458108
NJ
01
486391
AETNA PPO
NJ
01
529713
AETNA HMO
NJ
01
5356729010
CIGNA HMO PCP
NJ
01
5356729014
CIGNA HMO SPECIALIST
NJ
01
BP481
OXFORD
NJ
Enumeration date
03/03/2006
Last updated
07/09/2007
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