Healthcare Provider Details

I. General information

NPI: 1508808262
Provider Name (Legal Business Name): ADVANCED GASTROENTEROLOGY OF BERGEN COUNTY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 SYLVAN AVE SUITE 101A
ENGLEWOOD CLIFFS NJ
07632-2514
US

IV. Provider business mailing address

140 SYLVAN AVE SUITE 101A
ENGLEWOOD CLIFFS NJ
07632-2514
US

V. Phone/Fax

Practice location:
  • Phone: 201-945-6564
  • Fax: 201-461-9038
Mailing address:
  • Phone: 201-945-6564
  • Fax: 201-461-9038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BARRY M. ZINGLER
Title or Position: VICE-PRESIDENT
Credential: M.D.
Phone: 201-945-6564