Healthcare Provider Details

I. General information

NPI: 1700014545
Provider Name (Legal Business Name): GARDEN STATE HEALTHCARE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 E 29TH ST
BAYONNE NJ
07002-4654
US

IV. Provider business mailing address

308 WILLOW AVENUE
HOBOKEN NJ
07030-4654
US

V. Phone/Fax

Practice location:
  • Phone: 844-242-7436
  • Fax: 201-603-6677
Mailing address:
  • Phone: 201-821-8717
  • Fax: 201-603-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK SPEKTOR
Title or Position: SOLE OWNER
Credential: D.O.
Phone: 201-858-7111