MEDICARE: GREGORY M RIEDLINGER MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0007X	Molecular Genetic Pathology (Pathology) Physician	25MA09738600	NJ
2	207ZP0101X	Anatomic Pathology Physician	25MA09738600	NJ
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	L-255276	MA
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	25MA09738600	NJ

General Provider Information

NPI Number	:	1639516891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY M RIEDLINGER MD, PHD

Provider Business Mailing Address
First Line	:	195 LITTLE ALBANY ST RM 3553
Second Line	:
City	:	NEW BRUNSWICK
State	:	NJ
Zip	:	08901-1914
Country	:	US
Telephone Number	:	732-235-8978
Fax Number	:

Provider Business Practice Location Address
First Line	:	RUTGERS CANCER INSTITUTE OF NEW JERSEY
Second Line	:	195 LITTLE ALBANY PARKWAY, ROOM 3553
City	:	NEW BRUNSWICK
State	:	NJ
Zip	:	08903-0890
Country	:	US
Telephone Number	:	732-235-8978
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2013
Last Update Date	:	10/30/2024

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