Provider Demographics
NPI:1952483323
Name:BZ GASTROINTESTINAL PA
Entity Type:Organization
Organization Name:BZ GASTROINTESTINAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:V
Authorized Official - Last Name:MAGASIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-983-1333
Mailing Address - Street 1:100 BRICK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-983-1333
Mailing Address - Fax:856-983-9292
Practice Address - Street 1:100 BRICK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-983-1333
Practice Address - Fax:856-983-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA56820207RG0100X
NJMA58049207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD6195OtherRAILROAD MEDICARE
NJ30528000Medicaid
NJ30528000Medicaid