Provider Demographics
NPI:1245313527
Name:GANZON-ZAMPINO, GILDA E (MD)
Entity type:Individual
Prefix:DR
First Name:GILDA
Middle Name:E
Last Name:GANZON-ZAMPINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SCHOONER LANDING RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-3133
Mailing Address - Country:US
Mailing Address - Phone:609-404-9737
Mailing Address - Fax:
Practice Address - Street 1:501 WEST FRONT STREET
Practice Address - Street 2:
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318
Practice Address - Country:US
Practice Address - Phone:856-363-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06517500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ082718QEBMedicare PIN
NJI16284Medicare UPIN