MEDICARE: GILBERTO F GASTELL MD PA

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	174400000X	Specialist	25MA04575900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0041988003	OTHER	NJ	AMERIHEALTH (ENGLEWOOD)
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0041988001	OTHER	NJ	AMERIHEALTH (UNION CITY)

General Provider Information

NPI Number	:	1184662678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILBERTO F GASTELL MD PA

Provider Business Mailing Address
First Line	:	408 37TH ST
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-4804
Country	:	US
Telephone Number	:	201-864-4477
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 37TH ST
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-4804
Country	:	US
Telephone Number	:	201-864-4477
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GILBERTO GASTELL
Credential	:	MD
Telephone Number	:	201-864-4477

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	09/28/2007

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