Provider Demographics
NPI:1093750929
Name:KATHLEEN M. GEKOWSKI MD PA
Entity Type:Organization
Organization Name:KATHLEEN M. GEKOWSKI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BITTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-882-3500
Mailing Address - Street 1:1450 PARKSIDE AVENUE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638
Mailing Address - Country:US
Mailing Address - Phone:609-882-3500
Mailing Address - Fax:609-882-3501
Practice Address - Street 1:1450 PARKSIDE AVENUE
Practice Address - Street 2:SUITE #4
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638
Practice Address - Country:US
Practice Address - Phone:609-882-3500
Practice Address - Fax:609-882-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA040640207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9125108Medicaid
NJ067798Medicare PIN
C58247Medicare UPIN