Advanced Gastroenterology, PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

25MA037333 Issued in NJ

Legal business name

ADVANCED GASTROENTEROLOGY, PA

Practice address

741 Northfield Avenue
Suite 204
West Orange, NJ 07052

Phone

(973) 731-8686

Fax

(973) 731-1911

NPI assigned

Sep 8, 2010

Last updated

Sep 8, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Glen R Mogan, MD

Title

Owner

Phone

(973) 731-8686

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1164739447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 NORTHFIELD AVENUE",
            "address_2": "SUITE 204",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-731-8686",
            "fax_number": "973-731-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 NORTHFIELD AVENUE",
            "address_2": "SUITE 204",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-731-8686",
            "fax_number": "973-731-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GASTROENTEROLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "MOGAN",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-731-8686",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA037333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olugbenga Adesokan
• Adjust Chiropractic Health Center
• Adrian L. Connolly MD LLC
• Advance Medicine of West Essex PA
• Advanced Dermatology Associates, P.a.
• Advanced Orthopaedic & Joint Replacement Center PA
• Advanced Urologic Care Associates, P.C.
• Advanced Wellness Center of Essex County, P.C.
• Sonoo Kishu Advani, M.D.
• Advocare , LLC (Advocare Lovenheim Pediatrics)

• Gastroenterology Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.