Organization Name: | THE GEM MEDICAL GROUP |
NPI Number: | 1750592879 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CINDY WILNO (BILLING MANAGER) |
Mailing Address: | 51 Route 23 South Riverdale |
State: | NJ US |
Postal Code: | 07456 |
Phone Number: | 9738315705 |
Fax Number: | 9738315706 |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 09/21/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MA05022000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |