Provider Demographics
NPI:1033213236
Name:MISKO, GARY JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:JOHN
Last Name:MISKO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1269
Mailing Address - Country:US
Mailing Address - Phone:732-287-6004
Mailing Address - Fax:732-287-3575
Practice Address - Street 1:267 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1269
Practice Address - Country:US
Practice Address - Phone:732-287-6004
Practice Address - Fax:732-287-3575
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA62917207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8637489OtherCIGNA
110245387OtherMEDICARE RAIL ROAD
223623486OtherHORIZON PPO
1734357OtherFIRST HEALTH
31832OtherMASTERCARE
40049OtherMEDICHOICE
P1934612OtherOXFORD
1737406OtherUNITED HEALTHCARE
1K2138OtherHEALTHNET
2185368OtherAETNA
23641OtherAETNA CAP
4H8791OtherWELLCHOICE
0462541000OtherAMERIHEALTH PPO
0744764001OtherAMERIHEALTH HMOPOS
2596853OtherGHI
J7960OtherHORIZON HMOPOS
4H8791OtherWELLCHOICE
8637489OtherCIGNA