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General NPI Number Information
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NPI Number | 1275726697
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Entity Type | Individual
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Provider Name | GAIL PORAT
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Gender | Female
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 406 LIPPINCOTT DR STE E
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City | MARLTON
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State | NJ
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Zip | 08053-4168
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Country | US
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Telephone | 856-983-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 35 OLD STEVENS LN
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City | VOORHEES
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State | NJ
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Zip | 08043-3417
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Country | US
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Telephone | 516-242-7624
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Fax |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD432112
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License Number State | PA
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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 | 25MA10230400
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License Number State | NJ
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