Healthcare Provider Details

I. General information

NPI: 1396699112
Provider Name (Legal Business Name): DAVID GENDY NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 WESTFIELD AVE
ELIZABETH NJ
07208-1621
US

IV. Provider business mailing address

PO BOX 343
ROCHELLE PARK NJ
07662-0343
US

V. Phone/Fax

Practice location:
  • Phone: 908-677-5900
  • Fax:
Mailing address:
  • Phone: 201-234-9105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15532800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: