Provider Demographics
NPI:1033544531
Name:GJMEC & LT LLC
Entity Type:Organization
Organization Name:GJMEC & LT LLC
Other - Org Name:DOC VISITS AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GENNARO
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:SR
Authorized Official - Credentials:DO
Authorized Official - Phone:201-650-1855
Mailing Address - Street 1:54 NICOLE DR
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-9531
Mailing Address - Country:US
Mailing Address - Phone:201-650-1855
Mailing Address - Fax:973-366-4315
Practice Address - Street 1:54 NICOLE DR
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-9531
Practice Address - Country:US
Practice Address - Phone:201-650-1855
Practice Address - Fax:973-366-4315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative MedicineGroup - Multi-Specialty