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General NPI Number Information
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NPI Number | 1942200472
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Entity Type | Individual
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Provider Name | GILBERTO GASTELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2005
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 408 37TH ST
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City | UNION CITY
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State | NJ
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Zip | 07087-4804
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Country | US
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Telephone | 201-864-4477
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Fax | 201-864-9727
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Provider Business Mailing Address
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Address Line | 718 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4245
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Country | US
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Telephone | 201-833-7265
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Fax | 201-227-6207
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA04575900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA04575900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA04575900
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License Number State | NJ
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