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General NPI Number Information
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NPI Number | 1477599322
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY ASSOC. OF NORTH JERSEY
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 369 W BLACKWELL ST
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City | DOVER
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State | NJ
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Zip | 07801-2560
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Country | US
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Telephone | 973-361-7660
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Fax | 973-361-0455
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Provider Business Mailing Address
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Address Line | 369 W BLACKWELL ST
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City | DOVER
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State | NJ
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Zip | 07801-2560
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Country | US
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Telephone | 973-361-7660
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Fax | 973-361-0455
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARRY S. BENEROFE
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Credential | M.D.
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Telephone | 973-361-7660
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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 |
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License Number State |
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