Provider Demographics
NPI:1942423538
Name:GERALD E PFLUM MD PA
Entity Type:Organization
Organization Name:GERALD E PFLUM MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATION SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PFLUM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:732-775-1301
Mailing Address - Street 1:444 NEPTUNE BLVD
Mailing Address - Street 2:UNIT 12
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4121
Mailing Address - Country:US
Mailing Address - Phone:732-775-1301
Mailing Address - Fax:732-775-0507
Practice Address - Street 1:444 NEPTUNE BLVD
Practice Address - Street 2:UNIT 12
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4121
Practice Address - Country:US
Practice Address - Phone:732-775-1301
Practice Address - Fax:732-775-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA032941207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0049667OtherAETNA
NJ0441233000OtherAMERIHEALTH
NJF02133OtherHEALTHNET OF THE NORTHEAS
NJ0094161OtherGHI
NJ2003902Medicaid
NJ32249OtherEMPIRE BS
NJ0004093717OtherAETNA HMO
NJMS249OtherOXFORD
NJ0094161OtherGHI
NJ=========0003OtherCIGNA
NJ2003902Medicaid
NJF02133OtherHEALTHNET OF THE NORTHEAS
NJ0049667OtherAETNA
NJ=========001OtherQUALCARE
NJMS249OtherOXFORD