Healthcare Provider Details

I. General information

NPI: 1952563520
Provider Name (Legal Business Name): ERIK LEONARD GELLELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 KUSER RD
HAMILTON NJ
08691-3386
US

IV. Provider business mailing address

3625 QUAKERBRIDGE RD RADIOLOGY AFFILIATES OF CENTRAL NEW JERSEY, PA
HAMILTON NJ
08619-1268
US

V. Phone/Fax

Practice location:
  • Phone: 609-585-8800
  • Fax: 609-585-1825
Mailing address:
  • Phone: 609-689-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD436259
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME161818
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA08514300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: