Provider Demographics
NPI:1265465900
Name:POON, GILBERT B (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:B
Last Name:POON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3799 US HIGHWAY 46
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1055
Mailing Address - Country:US
Mailing Address - Phone:973-334-8010
Mailing Address - Fax:973-402-9030
Practice Address - Street 1:3799 US HIGHWAY 46
Practice Address - Street 2:SUITE 209
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1055
Practice Address - Country:US
Practice Address - Phone:973-334-8010
Practice Address - Fax:973-402-9030
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04943700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0256501Medicaid
NJ440064Medicare ID - Type Unspecified
NJ0256501Medicaid