Provider Demographics
NPI:1033196381
Name:HACKENSACK DIGESTIVE DISEASE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:HACKENSACK DIGESTIVE DISEASE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOLDING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-488-3003
Mailing Address - Street 1:52 1ST ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2044
Mailing Address - Country:US
Mailing Address - Phone:201-488-3003
Mailing Address - Fax:201-488-6911
Practice Address - Street 1:52 1ST ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2044
Practice Address - Country:US
Practice Address - Phone:201-488-3003
Practice Address - Fax:201-488-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1033196381OtherNPI