Provider Demographics
NPI:1942596358
Name:GARY S. SAFIER DO, PC
Entity Type:Organization
Organization Name:GARY S. SAFIER DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAFIER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-989-1515
Mailing Address - Street 1:477 ROUTE 10 E STE 204
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2144
Mailing Address - Country:US
Mailing Address - Phone:973-989-1515
Mailing Address - Fax:973-989-4334
Practice Address - Street 1:477 ROUTE 10 E STE 204
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2144
Practice Address - Country:US
Practice Address - Phone:973-989-1515
Practice Address - Fax:973-989-4334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ054343Medicare PIN