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General NPI Number Information
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NPI Number | 1205983251
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Entity Type | Organization
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Legal Business Name | MICHAEL C GARTNER DO PC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 3 WINSLOW PL
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City | PARAMUS
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State | NJ
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Zip | 07652-2709
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Country | US
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Telephone | 201-546-1890
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Fax | 201-546-1893
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Provider Business Mailing Address
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Address Line | 3 WINSLOW PL
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City | PARAMUS
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State | NJ
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Zip | 07652-2709
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Country | US
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Telephone | 201-546-1890
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Fax | 201-546-1893
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | MICHAEL C GARTNER
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Credential | D.O.
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Telephone | 201-265-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MB06848500
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License Number State | NJ
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