| Organization Name: | GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, PA |
| NPI Number: | 1942267893 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL M MAINERO (PRESIDENT) |
| Mailing Address: | 205 Browertown Rd Suite 102 West Paterson |
| State: | NJ US |
| Postal Code: | 074242610 |
| Phone Number: | 9738904780 |
| Fax Number: | |
| NPI Enumeration Date: | 04/26/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |