| The Gastroenterology Group Of Northern New Jersey,llc | |
|
420 Grand Ave Suite 101 Englewood NJ 07631-4152 | |
| (201) 569-7044 | |
| (201) 569-1999 |
| Full Name | The Gastroenterology Group Of Northern New Jersey,llc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 420 Grand Ave, Englewood, New Jersey |
| Authorized Official Name and Position | Ivan A Friedrich (PHYSICIAN/BOARD OF GOVERNORS) |
| Authorized Official Contact | 2015697044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Gastroenterology Group Of Northern New Jersey,llc 420 Grand Ave Suite 101 Englewood NJ 07631 Ph: (201) 569-7044 | The Gastroenterology Group Of Northern New Jersey,llc 420 Grand Ave Suite 101 Englewood NJ 07631-4152 Ph: (201) 569-7044 |
| NPI Number | 1073944005 |
|---|---|
| Provider Enumeration Date | 12/02/2013 |
| Last Update Date | 12/10/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073944005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 25MA03997000 (New Jersey) | Primary |
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