Individual
GREGORY G EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
110 REHILL AVE, SOMERVILLE, NJ 08876-2519
(908) 685-2200
(732) 923-2272
Mailing address
379 CAMPUS DR, FL 4 CREDENTIALING, SOMERSET, NJ 08873-1161
(732) 937-8939
(732) 418-8372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00029600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
527111
MEDICARE RAILROAD
NJ
Enumeration date
11/12/2007
Last updated
06/28/2024
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