Provider Demographics
NPI:1518067297
Name:GRATZ, IRWIN (DO)
Entity Type:Individual
Prefix:
First Name:IRWIN
Middle Name:
Last Name:GRATZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST STE SW200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:856-356-4710
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER ANESTHESIA ASSOCIATES
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2425
Practice Address - Fax:856-968-8239
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB62170207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1138751OtherHORIZON NJ HEALTH
NJ843500OtherAMERIHEALTH PPO/PA BS
NJ1081257OtherHORIZON NJ HEALTH
NJ0876198000OtherAMERIHEALTH/KEYSTONE/IBC
NJ2455005Medicaid
NJ30262OtherUNIVERSITY HEATH PLAN
NJ010003810OtherAMERICHOICE
NJ0840843OtherAETNA
NJ2566062OtherUNITED HEALTHCARE
NJ2455005Medicaid
NJ010003810OtherAMERICHOICE
NJ843500 CK2Medicare PIN