MEDICARE: DR. FRANCIS EUGENE MCGORTY MD

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	207R00000X	Internal Medicine Physician	25MA059725	NJ

General Provider Information

NPI Number	:	1871557025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS EUGENE MCGORTY MD

Provider Business Mailing Address
First Line	:	190 DAYTON ST
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-4422
Country	:	US
Telephone Number	:	201-670-7800
Fax Number	:	201-670-7720

Provider Business Practice Location Address
First Line	:	190 DAYTON ST
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-4408
Country	:	US
Telephone Number	:	201-670-7800
Fax Number	:	201-670-7720

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	09/17/2010

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