Provider Demographics
NPI:1861551624
Name:GASTROENTEROLOGISTS OF OCEAN COUNTY PA
Entity type:Organization
Organization Name:GASTROENTEROLOGISTS OF OCEAN COUNTY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-349-4422
Mailing Address - Street 1:477 LAKEHURST RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6342
Mailing Address - Country:US
Mailing Address - Phone:732-349-4422
Mailing Address - Fax:732-349-8126
Practice Address - Street 1:477 LAKEHURST RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6342
Practice Address - Country:US
Practice Address - Phone:732-349-4422
Practice Address - Fax:732-349-8126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3267407Medicaid
NJ3267407Medicaid