Provider Demographics
NPI:1285663864
Name:HUNTERDON GASTROENTEROLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:HUNTERDON GASTROENTEROLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:COUGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-788-6448
Mailing Address - Street 1:1100 WESCOTT DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4600
Mailing Address - Country:US
Mailing Address - Phone:908-788-6448
Mailing Address - Fax:908-788-5090
Practice Address - Street 1:1100 WESCOTT DR
Practice Address - Street 2:SUITE 206
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4600
Practice Address - Country:US
Practice Address - Phone:908-788-6448
Practice Address - Fax:908-788-5090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3294803Medicaid
NJ718494Medicare ID - Type Unspecified
NJ3294803Medicaid