Provider Demographics
NPI:1063458180
Name:WEISFOGEL, GERALD M (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:M
Last Name:WEISFOGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2050 RTE 27
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1380
Mailing Address - Country:US
Mailing Address - Phone:732-821-5511
Mailing Address - Fax:732-821-5347
Practice Address - Street 1:3542 STATE ROUTE 27
Practice Address - Street 2:
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1050
Practice Address - Country:US
Practice Address - Phone:732-821-5562
Practice Address - Fax:732-821-5347
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03056300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ148661UV4Medicare ID - Type Unspecified
NJC57813Medicare UPIN