MEDICARE: SOMERSET GASTROENTEROLOGY

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	207RG0100X	Gastroenterology Physician	25MA08006700	NJ

General Provider Information

NPI Number	:	1366772014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMERSET GASTROENTEROLOGY

Provider Business Mailing Address
First Line	:	949 RIVER RD
Second Line	:
City	:	HILLSBOROUGH
State	:	NJ
Zip	:	08844-3349
Country	:	US
Telephone Number	:	908-566-6716
Fax Number	:

Provider Business Practice Location Address
First Line	:	949 RIVER RD
Second Line	:
City	:	HILLSBOROUGH
State	:	NJ
Zip	:	08844-3349
Country	:	US
Telephone Number	:	908-566-6716
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KEVIN SKOLE
Credential	:	MD
Telephone Number	:	908-566-6716

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	12/31/2009

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Directions to “SOMERSET GASTROENTEROLOGY ” Practice Location

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