| Paul W. Gwozdz, M.d., L.l.c. | |
|
710 Easton Ave Suite 1a Somerset NJ 08873-1855 | |
| (732) 545-4100 | |
| (732) 545-4102 |
| Full Name | Paul W. Gwozdz, M.d., L.l.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 710 Easton Ave, Somerset, New Jersey |
| Authorized Official Name and Position | Paul William Gwozdz (MANAGER) |
| Authorized Official Contact | 7325454100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul W. Gwozdz, M.d., L.l.c. 710 Easton Ave Suite 1a Somerset NJ 08873-1855 Ph: (732) 545-4100 | Paul W. Gwozdz, M.d., L.l.c. 710 Easton Ave Suite 1a Somerset NJ 08873-1855 Ph: (732) 545-4100 |
| NPI Number | 1881827517 |
|---|---|
| Provider Enumeration Date | 08/28/2009 |
| Last Update Date | 11/24/2016 |
| Medicare PECOS PAC ID | 3678612827 |
|---|---|
| Medicare Enrollment ID | O20091201000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881827517 | NPI | - | NPPES |
| 8397902 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Paul W Gwozdz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396786000 PECOS PAC ID: 6204975691 Enrollment ID: I20091124000397 |
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