Provider Demographics
NPI:1558478529
Name:SAFIER, GARY S (DO)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:S
Last Name:SAFIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:477 ST RT 10 E
Mailing Address - Street 2:STE 204
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2143
Mailing Address - Country:US
Mailing Address - Phone:973-989-1515
Mailing Address - Fax:973-989-4334
Practice Address - Street 1:477 RT 10 E
Practice Address - Street 2:ST 204
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869
Practice Address - Country:US
Practice Address - Phone:973-989-1515
Practice Address - Fax:973-989-4334
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB02393Z207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ054343Medicare PIN