MEDICARE: DR. JOEL JAY GARSTEN M.D

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	207RG0100X	Gastroenterology Physician	019371	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679521363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL JAY GARSTEN M.D

Provider Business Mailing Address
First Line	:	60 WESTWOOD AVE
Second Line	:	SUITE 314
City	:	WATERBURY
State	:	CT
Zip	:	06708-2460
Country	:	US
Telephone Number	:	203-574-3007
Fax Number	:	203-573-1739

Provider Business Practice Location Address
First Line	:	60 WESTWOOD AVE
Second Line	:	SUITE 314
City	:	WATERBURY
State	:	CT
Zip	:	06708-2460
Country	:	US
Telephone Number	:	203-574-3007
Fax Number	:	203-573-1739

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	06/30/2014

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