Healthcare Provider Details

I. General information

NPI: 1265831259
Provider Name (Legal Business Name): ALLIED DIGESTIVE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 ROUTE 36 MONMOUTH CORPORATE PARK CENTER I;BUILDING A, SUITE 230
WEST LONG BEACH NJ
07764
US

IV. Provider business mailing address

187 ROUTE 36 MONMOUTH CORPORATE PARK CENTER I;BUILDING A, SUITE 230
WEST LONG BEACH NJ
07764
US

V. Phone/Fax

Practice location:
  • Phone: 732-222-3805
  • Fax: 732-759-2799
Mailing address:
  • Phone: 732-222-3805
  • Fax: 732-759-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: KARL MEINERT
Title or Position: CHEIF ADMINISTRATIVE OFFICER
Credential:
Phone: 732-222-3815