Provider Demographics
NPI:1114354008
Name:G&A MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:G&A MEDICAL ASSOCIATES, LLC
Other - Org Name:DEVELOPMENTAL PEDIATRICS OF CENTRAL JERSEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-660-0220
Mailing Address - Street 1:25 ELLIS CT
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1806 HIGHWAY 35
Practice Address - Street 2:SUITE 107
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755
Practice Address - Country:US
Practice Address - Phone:732-660-0220
Practice Address - Fax:732-660-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB078703002080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty