Provider Demographics
NPI:1164694766
Name:GISELA MUNNE, M.D., LLC
Entity Type:Organization
Organization Name:GISELA MUNNE, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:MR
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:JESSE
Authorized Official - Last Name:SHEFFET
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:908-403-8182
Mailing Address - Street 1:2509 PARK AVE
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5300
Mailing Address - Country:US
Mailing Address - Phone:908-755-0590
Mailing Address - Fax:973-364-1919
Practice Address - Street 1:2509 PARK AVE
Practice Address - Street 2:SUITE 2C
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5300
Practice Address - Country:US
Practice Address - Phone:908-755-0590
Practice Address - Fax:973-364-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center