Provider Demographics
NPI:1376654129
Name:GRESSOCK, JOSEPH NEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:NEAL
Last Name:GRESSOCK
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 1:122 CLINTON ST
Mailing Address - Street 2:POD #2
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2502
Mailing Address - Country:US
Mailing Address - Phone:201-418-3102
Mailing Address - Fax:201-418-3147
Practice Address - Street 1:122 CLINTON ST
Practice Address - Street 2:POD #2
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2502
Practice Address - Country:US
Practice Address - Phone:201-418-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241101207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0134198Medicaid