Provider Demographics
NPI:1114992773
Name:RIHACEK, GREGORY SALVATORE (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SALVATORE
Last Name:RIHACEK
Suffix:
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 1:19 CLYDE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5042
Mailing Address - Country:US
Mailing Address - Phone:732-568-0023
Mailing Address - Fax:732-568-0159
Practice Address - Street 1:19 CLYDE RD
Practice Address - Street 2:#101
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5042
Practice Address - Country:US
Practice Address - Phone:732-568-0023
Practice Address - Fax:732-568-0159
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06373000207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJRI758540Medicare UPIN