Active NPI
Gizelle Manoah, PC, Inc
- Clinic/Center
- West Orange, NJ
National Provider Identifier
1225394075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- MA58440
- Legal business name
- GIZELLE MANOAH, PC, INC
- Practice address
- 59 Main St
Suite 204
West Orange, NJ 07052-5341 - Phone
- (973) 243-0220
- NPI assigned
- Apr 5, 2012
- Organization subpart
- Yes
- Parent organization
- GIZELLEMANOAH, PC, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anne-Marie Gizelle Gracia, MD
- Title
- President
- Phone
- (973) 243-0220
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | MA58440 | NJ | Primary |
Addresses
Primary practice location
59 Main St
Suite 204
West Orange, NJ 07052-5341
Mailing address
PO Box 3122
Memorial Station
Upper Montclair, NJ 07043-3122
Phone (973) 243-0220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6560610 | Medicaid | NJ |
National Provider Directory
National Provider Directory- Part of
- Gizelle Manoah PC Inc
Locations
59 Main St
Ste 204
West Orange, NJ 07052
Phone (973) 243-0220
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- West Orange, NJ
- NPI 1447328018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333584000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1333584000000",
"number": "1225394075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3122",
"address_2": "MEMORIAL STATION",
"city": "UPPER MONTCLAIR",
"state": "NJ",
"postal_code": "070433122",
"telephone_number": "973-243-0220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 MAIN ST",
"address_2": "SUITE 204",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070525341",
"telephone_number": "973-243-0220"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GIZELLE MANOAH, PC, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GIZELLEMANOAH, PC, INC",
"enumeration_date": "2012-04-05",
"last_updated": "2012-04-05",
"status": "A",
"authorized_official_last_name": "GRACIA",
"authorized_official_first_name": "ANNE-MARIE",
"authorized_official_middle_name": "GIZELLE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "973-243-0220",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NJ",
"license": "MA58440",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6560610",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.