Individual
GARY I GORODOKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24-07 A BROADWAY, FAIR LAWN, NJ 07410
(201) 791-7760
(201) 791-7746
Mailing address
34 KNIGHTS COURT, UPPER SADDLE RIVER, NJ 07458
(201) 791-7760
(201) 791-7746
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
182511
NY
207RG0100X
Gastroenterology Physician
Primary
MA06159800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0K7399
HEALTH NET
NJ
01
—
2504592
GHI
—
01
—
3V7781
EMPIRE
NJ
01
—
5596271
AETNA
NJ
05
—
6878105
—
NJ
01
—
758683
EMPIRE
NY
01
—
ELDERPLAN
183559
NY
01
—
P698453
OXFORD
—
Enumeration date
07/19/2006
Last updated
03/15/2011
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