Organization
GERIATRICS AND INTERNAL MEDICINE ASSOCIATES OF NORTHEAST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANTHI GUNADASA MD, MBBS (OWNER)
(347) 308-4561
Entity
Organization
Contact information
Practice address
1 W RIDGEWOOD AVE, SUITE 203, PARAMUS, NJ 07652-2359
(347) 308-4561
Mailing address
1 W RIDGEWOOD AVE, SUITE 203, PARAMUS, NJ 07652-2359
(347) 308-4561
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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