Provider Demographics
NPI:1417996323
Name:GASTROENTEROLOGY CONSULTANTS, P.A.
Entity Type:Organization
Organization Name:GASTROENTEROLOGY CONSULTANTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOMSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-661-9225
Mailing Address - Street 1:205 MAY ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3267
Mailing Address - Country:US
Mailing Address - Phone:732-661-9225
Mailing Address - Fax:732-661-9259
Practice Address - Street 1:205 MAY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3267
Practice Address - Country:US
Practice Address - Phone:732-661-9225
Practice Address - Fax:732-661-9259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ145940Medicare UPIN