Organization
MIDDLESEX MONMOUTH GASTROENTEROLOGY
Active
Organization
MIDDLESEX MONMOUTH GASTROENTEROLOGY
Active
Other names
MMG Anesthesia Services
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DEBARD MPA (ADMINISTRATOR)
(732) 577-1999
Entity
Organization
Contact information
Practice address
222 SCHANCK RD, SUITE 100, FREEHOLD, NJ 07728-3068
(732) 577-1999
(732) 845-5356
Mailing address
222 SCHANCK RD, SUITE 100, FREEHOLD, NJ 07728-3068
(732) 577-1999
(732) 845-5356
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071151
MEDICARE PTAN
NJ
Enumeration date
06/28/2011
Last updated
06/28/2011
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