MEDICARE: GARDEN STATE RHEUMATOLOGY CONSULTANTS LLC

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
1	207RR0500X	Rheumatology Physician

General Provider Information

NPI Number	:	1083289326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDEN STATE RHEUMATOLOGY CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	PO BOX K
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-0389
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2333 MORRIS AVE STE B111
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-5717
Country	:	US
Telephone Number	:	908-977-1677
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RUNSHENG WANG
Credential	:	MD
Telephone Number	:	908-977-1677

Provider Enumeration Date	:	05/20/2021
Last Update Date	:	05/30/2026

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