Provider Demographics
NPI:1609124890
Name:ALEXANDER GUDZ LLC
Entity Type:Organization
Organization Name:ALEXANDER GUDZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUDZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-997-1100
Mailing Address - Street 1:62 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-1134
Mailing Address - Country:US
Mailing Address - Phone:973-986-5576
Mailing Address - Fax:
Practice Address - Street 1:62 MAIN AVE
Practice Address - Street 2:
Practice Address - City:WALLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07057-1134
Practice Address - Country:US
Practice Address - Phone:973-986-5576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty