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General NPI Number Information
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NPI Number | 1114933926
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Entity Type | Organization
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Legal Business Name | ESSEX GASTRO ASSOCIATES, PA
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 275 CHESTNUT ST
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City | NEWARK
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State | NJ
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Zip | 07105-1570
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Country | US
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Telephone | 973-589-5545
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Fax | 973-589-0073
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Provider Business Mailing Address
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Address Line | 275 CHESTNUT ST
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City | NEWARK
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State | NJ
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Zip | 07105-1570
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Country | US
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Telephone | 973-589-5545
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Fax | 973-589-0073
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FIRPO EUGENIO GUERRERO
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Credential | M.D.
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Telephone | 973-589-5545
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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 | 24MA04217500
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License Number State | NJ
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