Provider Demographics
NPI:1770557852
Name:CENTRAL JERSEY GASTROENTEROLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:CENTRAL JERSEY GASTROENTEROLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-780-4224
Mailing Address - Street 1:535 IRON BRIDGE RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5301
Mailing Address - Country:US
Mailing Address - Phone:732-780-4224
Mailing Address - Fax:732-780-5044
Practice Address - Street 1:535 IRON BRIDGE RD
Practice Address - Street 2:SUITE 12
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5301
Practice Address - Country:US
Practice Address - Phone:732-780-4224
Practice Address - Fax:732-780-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ526427Medicare ID - Type UnspecifiedMEDICARE ID