MEDICARE: LOUIS ANTHONY GAMBETTA DPM

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	213E00000X	Podiatrist	MD002231	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P368868	OTHER	NJ	OXFORD
3	2K1288	OTHER	NJ	ACS HEALTHNET
4	8292244	OTHER	NJ	CIGNA

General Provider Information

NPI Number	:	1588799209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS ANTHONY GAMBETTA DPM

Provider Business Mailing Address
First Line	:	275 PATERSON AVE
Second Line	:	FIRST FLOOR
City	:	LITTLE FALLS
State	:	NJ
Zip	:	07424-5627
Country	:	US
Telephone Number	:	973-785-3334
Fax Number	:	973-785-7760

Provider Business Practice Location Address
First Line	:	275 PATERSON AVE
Second Line	:	FIRST FLOOR
City	:	LITTLE FALLS
State	:	NJ
Zip	:	07424-5627
Country	:	US
Telephone Number	:	973-785-3334
Fax Number	:	973-785-7760

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	09/05/2008

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Directions to “ LOUIS ANTHONY GAMBETTA DPM” Practice Location

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