Provider Demographics
NPI:1457307340
Name:GREGORY, JOHN JOSEPH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:GREGORY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 MADISON AVE
Mailing Address - Street 2:BOX 70
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6136
Mailing Address - Country:US
Mailing Address - Phone:973-971-6720
Mailing Address - Fax:973-401-2410
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:BOX 70
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-6720
Practice Address - Fax:973-401-2410
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2008-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA069446002080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02257165Medicaid
D96386Medicare UPIN
NY02257165Medicaid