| The Center For Gastroenterology And Liver Disorders Llc | |
|
255 State Rt 3 Suite 210 Secaucus NJ 07094-3857 | |
| (201) 866-2400 | |
| (201) 866-0444 |
| Full Name | The Center For Gastroenterology And Liver Disorders Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 255 State Rt 3, Secaucus, New Jersey |
| Authorized Official Name and Position | Wayne D Siegel (PRESIDENT) |
| Authorized Official Contact | 2018662400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Center For Gastroenterology And Liver Disorders Llc 255 State Rt 3 Suite 210 Secaucus NJ 07094-3857 Ph: (201) 866-2400 | The Center For Gastroenterology And Liver Disorders Llc 255 State Rt 3 Suite 210 Secaucus NJ 07094-3857 Ph: (201) 866-2400 |
| NPI Number | 1497874358 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5698737328 |
|---|---|
| Medicare Enrollment ID | O20041103001024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497874358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MA50168 (New Jersey) | Primary |
| Provider Name | Wayne D Siegel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063409191 PECOS PAC ID: 5395707020 Enrollment ID: I20041103001069 |
| Provider Name | Charles T Ladoulis |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538321609 PECOS PAC ID: 9436296563 Enrollment ID: I20110321000596 |
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