| Garden State Gastroenterology,pc | |
|
200 Perrine Rd Suite 231 Old Bridge NJ 08857-2842 | |
| (732) 525-0600 | |
| (732) 525-9777 |
| Full Name | Garden State Gastroenterology,pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 200 Perrine Rd, Old Bridge, New Jersey |
| Authorized Official Name and Position | Tracey Drevelus Hom (OFFICE MANAGER) |
| Authorized Official Contact | 7325250600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Gastroenterology,pc Po Box 209 Wickatunk NJ 07765-0209 Ph: (732) 525-0600 | Garden State Gastroenterology,pc 200 Perrine Rd Suite 231 Old Bridge NJ 08857-2842 Ph: (732) 525-0600 |
| NPI Number | 1215124524 |
|---|---|
| Provider Enumeration Date | 10/01/2007 |
| Last Update Date | 10/01/2007 |
| Medicare PECOS PAC ID | 1658356498 |
|---|---|
| Medicare Enrollment ID | O20040624000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215124524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MA59602 (New Jersey) | Primary |
| Provider Name | Seema Handa Nayyar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144295445 PECOS PAC ID: 1456257153 Enrollment ID: I20040116000232 |
| Provider Name | Sanjeev Nayyar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033193628 PECOS PAC ID: 4284629247 Enrollment ID: I20040423000199 |
| Provider Name | John A Renda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447227566 PECOS PAC ID: 0941493043 Enrollment ID: I20101021000640 |
| Provider Name | Lucy Rivilis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225471568 PECOS PAC ID: 7012157951 Enrollment ID: I20130717000297 |
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