Provider Demographics
NPI:1710964770
Name:FOOS, GREGG R (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:R
Last Name:FOOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:776 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3006
Mailing Address - Country:US
Mailing Address - Phone:732-530-4949
Mailing Address - Fax:732-212-1171
Practice Address - Street 1:776 SHREWSBURY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3006
Practice Address - Country:US
Practice Address - Phone:732-530-4949
Practice Address - Fax:732-530-3618
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2013-03-13
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Provider Licenses
StateLicense IDTaxonomies
NJMA58891207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1295733OtherUNITED HEALTHCARE
NJ200026581OtherRR MEDICARE
NJ932288OtherPHS/GUARDIAN
NJP888554OtherOXFORD
NJ973769OtherAETNA
NJCC3884OtherRR MEDICARE GRP#
NJ310212600OtherUS DEPT OF LABOR
NJ6962009Medicaid
NJJ29976OtherHEALTHNET
NJ3222403Medicaid
NJJ29976OtherHEALTHNET
NJ3222403Medicaid
NJ200026581OtherRR MEDICARE