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General NPI Number Information
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NPI Number | 1043295017
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN GASTROENTEROLOGY OF UNION COUNTY PA
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 210 NORTH AVE E
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City | CRANFORD
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State | NJ
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Zip | 07016-2441
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Country | US
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Telephone | 908-272-6300
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Fax | 908-272-6302
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Provider Business Mailing Address
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Address Line | 210 NORTH AVE E
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City | CRANFORD
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State | NJ
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Zip | 07016-2441
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Country | US
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Telephone | 908-272-6300
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Fax | 908-272-6302
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL LEONARD MARGOLIN
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Credential | MD
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Telephone | 908-272-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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