Provider Demographics
NPI:1942408026
Name:GARA M. SOMMERS, MD, PC
Entity Type:Organization
Organization Name:GARA M. SOMMERS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZABON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-238-4613
Mailing Address - Street 1:718 TEANECK RD
Mailing Address - Street 2:CLINICAL RESEARCH SECTION
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4245
Mailing Address - Country:US
Mailing Address - Phone:201-792-9011
Mailing Address - Fax:201-833-3282
Practice Address - Street 1:718 TEANECK RD
Practice Address - Street 2:CLINICAL RESEARCH SECTION
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4245
Practice Address - Country:US
Practice Address - Phone:201-792-9011
Practice Address - Fax:201-833-3282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05875200207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5343402Medicaid
NJB12351Medicare UPIN
NJ5343402Medicaid