Provider Demographics
NPI:1982982336
Name:G&S MEDICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:G&S MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAMMAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASSANIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-523-4000
Mailing Address - Street 1:606 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1916
Mailing Address - Country:US
Mailing Address - Phone:973-679-0393
Mailing Address - Fax:973-689-3081
Practice Address - Street 1:606 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1916
Practice Address - Country:US
Practice Address - Phone:973-523-1800
Practice Address - Fax:973-689-3081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0427268Medicaid
NJ0140058Medicaid