Provider Demographics
NPI:1639495187
Name:NEW JERSEY DIGESTIVE DISEASE ASSOCIATES, PC
Entity Type:Organization
Organization Name:NEW JERSEY DIGESTIVE DISEASE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACALINCAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-499-8000
Mailing Address - Street 1:999 RARITAN RD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1757
Mailing Address - Country:US
Mailing Address - Phone:732-499-8000
Mailing Address - Fax:732-396-9413
Practice Address - Street 1:999 RARITAN RD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1757
Practice Address - Country:US
Practice Address - Phone:732-499-8000
Practice Address - Fax:732-396-9413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty