Provider Demographics
NPI:1881017739
Name:CENTRAL JERSEY HAND SURGERY
Entity Type:Organization
Organization Name:CENTRAL JERSEY HAND SURGERY
Other - Org Name:NEW JERSEY HAND SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:PESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-542-4477
Mailing Address - Street 1:2 INDUSTRIAL WAY W
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2265
Mailing Address - Country:US
Mailing Address - Phone:732-542-4477
Mailing Address - Fax:732-935-0355
Practice Address - Street 1:780 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5059
Practice Address - Country:US
Practice Address - Phone:732-286-9000
Practice Address - Fax:732-240-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04833900207XS0106X
NJ25MA04697300207XS0106X
NJ25MA05950600207XS0106X
NJ25MAO6943100207XS0106X
NJ25MAO77700002086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2371707Medicaid
NJ7992505Medicaid
NJ5519501Medicaid
NJ0103667Medicaid
NJ0432105Medicaid
NJ027982N6QMedicare PIN
NJE54786Medicare UPIN
NJI50656Medicare UPIN
NJ0432105Medicaid
NJ508678N6QMedicare PIN
NJE55118Medicare UPIN
NJ5519501Medicaid
NJ746645N6QMedicare PIN
NJG95373Medicare UPIN
NJ613784N6QMedicare PIN