Provider Demographics
NPI:1659346765
Name:GASTROENTEROLOGY CONSULTANTS OF TOMS RIVER PC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY CONSULTANTS OF TOMS RIVER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUATENGCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-341-7460
Mailing Address - Street 1:9 MULE RD
Mailing Address - Street 2:SUITE E15
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5043
Mailing Address - Country:US
Mailing Address - Phone:732-341-7460
Mailing Address - Fax:732-914-9088
Practice Address - Street 1:9 MULE RD
Practice Address - Street 2:SUITE E15
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5043
Practice Address - Country:US
Practice Address - Phone:732-341-7460
Practice Address - Fax:732-914-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3372953OtherAETNA
NJ076229Medicare ID - Type Unspecified