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General NPI Number Information
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NPI Number | 1033889589
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Entity Type | Organization
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Legal Business Name | ESSEX DIGESTIVE HEALTHCARE PC
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 2060 MILLBURN AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3713
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Country | US
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Telephone | 973-642-3155
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Fax | 973-642-0047
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Provider Business Mailing Address
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Address Line | 92 W MCCLELLAN AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1245
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Country | US
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Telephone | 973-642-3155
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Fax | 973-642-0047
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMOL SHAH
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Credential | MD
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Telephone | 973-634-2184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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