| Gastrocare, Llc | |
|
571 Central Avenue Suite 112 New Providence NJ 07974 | |
| (908) 522-1313 | |
| (908) 522-1302 |
| Full Name | Gastrocare, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 571 Central Avenue, New Providence, New Jersey |
| Authorized Official Name and Position | Amber Manzoor Khan (PHYSICIAN) |
| Authorized Official Contact | 9085221313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastrocare, Llc 571 Central Avenue Suite 112 New Providence NJ 07974 Ph: (908) 522-1313 | Gastrocare, Llc 571 Central Avenue Suite 112 New Providence NJ 07974 Ph: (908) 522-1313 |
| NPI Number | 1497873244 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 10/24/2012 |
| Medicare PECOS PAC ID | 3173690096 |
|---|---|
| Medicare Enrollment ID | O20080918000437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497873244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MA72090 (New Jersey) | Primary |
| Provider Name | Amber M Khan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508958471 PECOS PAC ID: 0749259679 Enrollment ID: I20040928000815 |
| Provider Name | Michael A Gistrak |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396793972 PECOS PAC ID: 3870665318 Enrollment ID: I20080628000069 |
| Provider Name | Scott Merlin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1124244009 PECOS PAC ID: 2163560897 Enrollment ID: I20091117000348 |
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