MEDICARE: GGI HEALTH 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	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1215753322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GGI HEALTH LLC

Provider Business Mailing Address
First Line	:	404 VIBURNUM CT
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-5203
Country	:	US
Telephone Number	:	732-379-3221
Fax Number	:	848-200-1139

Provider Business Practice Location Address
First Line	:	180 TICES LN STE 101
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1345
Country	:	US
Telephone Number	:	732-379-3221
Fax Number	:	848-200-1139

Authorized Official
Title or Position	:	APN
Name	:	RICHARD WANGA
Credential	:
Telephone Number	:	732-379-3221

Provider Enumeration Date	:	11/25/2024
Last Update Date	:	06/18/2026

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Directions to “GGI HEALTH LLC ” Practice Location

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