Provider Demographics
NPI:1548214067
Name:GREGORY E BROSLAWSKI DO, HUNTERDON INTERNAL MEDICINE ASSOCS
Entity Type:Organization
Organization Name:GREGORY E BROSLAWSKI DO, HUNTERDON INTERNAL MEDICINE ASSOCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROSLAWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:908-782-8019
Mailing Address - Street 1:6 SAND HILL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4946
Mailing Address - Country:US
Mailing Address - Phone:908-782-8019
Mailing Address - Fax:
Practice Address - Street 1:6 SAND HILL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4946
Practice Address - Country:US
Practice Address - Phone:908-782-8019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF62148Medicare UPIN
NJ070862Medicare PIN