Doctor Name: | DR. JAMES GENTILE |
NPI Number: | 1376507814 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 25MB06301800 |
Business Practice Address: | 2 Swackhamer Rd Whitehouse Station, NJ - 088893025 |
Business Phone Number: | 9085348630 |
Business Fax Number: | |
Mailing Address: | 37 N Fullerton Ave, MONTCLAIR |
State: | NJ |
Postal Code: | 070423426 |
Phone Number: | 9732330433 |
Fax Number: | 9732330144 |
NPI Enumeration Date: | 04/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204C00000X |
License Number: | 25MB06301800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
Taxonomy Specialization: | |
Taxonomy Definition: |