Provider Demographics
NPI:1477792810
Name:GERIATRIC HOUSE CALL PHYSICIANS PC
Entity Type:Organization
Organization Name:GERIATRIC HOUSE CALL PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MRANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-387-2003
Mailing Address - Street 1:175 WASHINGTON AVE STE 17
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2936
Mailing Address - Country:US
Mailing Address - Phone:201-387-2003
Mailing Address - Fax:201-387-2277
Practice Address - Street 1:175 WASHINGTON AVE STE 17
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-2936
Practice Address - Country:US
Practice Address - Phone:201-387-2003
Practice Address - Fax:201-387-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06631600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty