Healthcare Provider Details

I. General information

NPI: 1003052549
Provider Name (Legal Business Name): ADVANCED GASTROENTEROLOGY CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date: 05/12/2026
Reactivation Date: 07/08/2026

III. Provider practice location address

1103 WESTFIELD AVE
RAHWAY NJ
07065-1916
US

IV. Provider business mailing address

1103 WESTFIELD AVE
RAHWAY NJ
07065-1916
US

V. Phone/Fax

Practice location:
  • Phone: 908-688-8080
  • Fax: 732-381-1101
Mailing address:
  • Phone: 908-688-8080
  • Fax: 732-381-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAVAN SACHAN
Title or Position: PRESIDENT
Credential: MD
Phone: 908-688-8080