MEDICARE: GENE MEDICAL GROUP, 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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1871846154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENE MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	1101 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6329
Country	:	US
Telephone Number	:	201-917-5258
Fax Number	:	201-917-5290

Provider Business Practice Location Address
First Line	:	1101 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6329
Country	:	US
Telephone Number	:	201-917-5258
Fax Number	:	201-917-5290

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HENRY LEE
Credential	:
Telephone Number	:	201-567-7725

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	07/26/2024

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Directions to “GENE MEDICAL GROUP, LLC ” Practice Location

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