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NPI Code Detail

MEDICARE: DR. GILBERTO GASTELL M.D.

MEDICARE:  DR. GILBERTO  GASTELL  M.D.
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
1174400000XSpecialist25MA04575900NJ
2207R00000XInternal Medicine Physician25MA04575900NJ
3207Q00000XFamily Medicine Physician25MA04575900NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1398670OTHERNJWELLCARE
2929783OTHERNJAETNA HMO ID #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
413270OTHERNJUNIVERSITY HEALTH PLANS
554C141OTHERNJEMPIRE BC/BS (UNION CITY)
6P00256277OTHERNJRR MDCR #
7239SU1OTHERNJEMPIRE BC/BS (ENGLEWOOD)
89611335OTHERNJGHI ID #
90111479000OTHERNJAMERIHEALTH #
10HP107OTHERNJOXFORD ID #
114092912OTHERNJAETNA PPO ID #

General Provider Information

NPI Number : 1942200472
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GILBERTO GASTELL M.D.
Provider Business Mailing Address
First Line : 718 TEANECK RD
Second Line :
City : TEANECK
State : NJ
Zip : 07666-4245
Country : US
Telephone Number : 201-833-7265
Fax Number : 201-227-6207
Provider Business Practice Location Address
First Line : 408 37TH ST
Second Line :
City : UNION CITY
State : NJ
Zip : 07087-4804
Country : US
Telephone Number : 201-864-4477
Fax Number : 201-864-9727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2005
Last Update Date : 05/26/2011

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