Provider Demographics
NPI:1689888281
Name:GARY B SINENSKY MD PA
Entity Type:Organization
Organization Name:GARY B SINENSKY MD PA
Other - Org Name:NORTH EASTERN GASTROENTEROLOGY ASSOCIATES , PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SINENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-344-4787
Mailing Address - Street 1:24-28 MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-2847
Mailing Address - Country:US
Mailing Address - Phone:973-344-4787
Mailing Address - Fax:
Practice Address - Street 1:24-28 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2847
Practice Address - Country:US
Practice Address - Phone:973-344-4787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA38546207RG0100X
NJ38548207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7369204Medicaid
440618Medicare PIN
NJ7369204Medicaid