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General NPI Number Information
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NPI Number | 1194738708
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Entity Type | Individual
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Provider Name | MAGED MOUSSA GERGES MD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 1 CLARA MAASS DRIVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109
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Country | US
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Telephone | 908-653-9399
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Fax | 908-853-9305
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Provider Business Mailing Address
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Address Line | 1305 WALT WHITMAN RD STE 300
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City | MELVILLE
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State | NY
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Zip | 11747-4300
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Country | US
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Telephone | 516-945-3000
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Fax | 516-945-3131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA07378500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 223515
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License Number State | NY
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