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NPI Code Detail

MEDICARE: MICHAEL A. GERSTMANN M.D.

MEDICARE: MICHAEL A. GERSTMANN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMA07577400NJ

General Provider Information

NPI Number : 1073510947
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL A. GERSTMANN M.D.
Provider Business Mailing Address
First Line : 183 S ORANGE AVE
Second Line : BHSB B-1455
City : NEWARK
State : NJ
Zip : 07103-2757
Country : US
Telephone Number : 973-972-6479
Fax Number : 973-972-8626
Provider Business Practice Location Address
First Line : 183 S ORANGE AVE
Second Line : BHSB B-1455
City : NEWARK
State : NJ
Zip : 07103-2757
Country : US
Telephone Number : 973-972-6479
Fax Number : 973-972-8626
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 02/08/2022

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