Provider Demographics
NPI:1942242318
Name:GAMIL MAKAR MD LLC
Entity Type:Organization
Organization Name:GAMIL MAKAR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GAMIL
Authorized Official - Middle Name:LAMEY
Authorized Official - Last Name:MAKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:862-249-4901
Mailing Address - Street 1:1700 ROUTE 3
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3928
Mailing Address - Country:US
Mailing Address - Phone:862-249-4901
Mailing Address - Fax:973-928-2650
Practice Address - Street 1:1700 ROUTE 3 WEST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:862-249-4901
Practice Address - Fax:973-928-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07631500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0024546Medicaid
2373594001OtherAMERIHEALTH
NJI05099Medicare UPIN
NJ0024546Medicaid