Individual
MICHAEL RAYMOND GENTILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 FRANKLIN AVE, NUTLEY, NJ 07110-1209
(973) 542-1122
(973) 661-1300
Mailing address
655 FRANKLIN AVE, NUTLEY, NJ 07110-1209
(973) 542-1122
(973) 661-1300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA050612
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0922404
—
NJ
Enumeration date
01/30/2006
Last updated
07/19/2010
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