| Nj Gastro, Llc | |
|
24 Merchant St Newark NJ 07105-2847 | |
| (972) 645-0000 | |
| (973) 645-0001 |
| Full Name | Nj Gastro, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 24 Merchant St, Newark, New Jersey |
| Authorized Official Name and Position | Domenica Maria Barritta (OWNER) |
| Authorized Official Contact | 9736450000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nj Gastro, Llc 24 Merchant St Newark NJ 07105-2847 Ph: (973) 645-0000 | Nj Gastro, Llc 24 Merchant St Newark NJ 07105-2847 Ph: (972) 645-0000 |
| NPI Number | 1851525661 |
|---|---|
| Provider Enumeration Date | 05/07/2009 |
| Last Update Date | 01/22/2020 |
| Medicare PECOS PAC ID | 7911058169 |
|---|---|
| Medicare Enrollment ID | O20090629000197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851525661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (New Jersey) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Stacey L Longo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1184799223 PECOS PAC ID: 4688661002 Enrollment ID: I20040428000464 |
| Provider Name | Domenica M Barritta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063428878 PECOS PAC ID: 5496719734 Enrollment ID: I20041116000744 |
| Provider Name | Gregory Scott Lesser |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023096575 PECOS PAC ID: 6507803251 Enrollment ID: I20070711000301 |
| Provider Name | Sinisa Ivelja |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205070471 PECOS PAC ID: 0941521355 Enrollment ID: I20150610000354 |
| Provider Name | Eliezer Y Weiss |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891939187 PECOS PAC ID: 8123335601 Enrollment ID: I20150916000535 |
| Provider Name | Dhanmatie Baldeo-dat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104244177 PECOS PAC ID: 6800198797 Enrollment ID: I20160108002364 |
| Provider Name | Darren J Gorman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972007078 PECOS PAC ID: 4284979212 Enrollment ID: I20220628003075 |
| Provider Name | Adam Ray Pont |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215356530 PECOS PAC ID: 0749663177 Enrollment ID: I20220818000976 |
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