Genesis Addiction and Behavioral Medicine, LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

25MB05783900 Issued in NJ

Legal business name

GENESIS ADDICTION AND BEHAVIORAL MEDICINE, LLC

Practice address

179 High St Ste 101
Newton, NJ 07860-1010

Phone

(973) 862-4297

Fax

(973) 327-7760

NPI assigned

Apr 20, 2018

Last updated

Jun 28, 2023By 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

Michael R. Ganon, DONPI 1992758007

Title

Medical Director

Phone

(973) 862-4297

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael R. Ganon, D.O.

  • Addiction Medicine (Family Medicine) Physician
  • Newton, NJ
  • NPI 1992758007
  NPD Authorized official

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1487141883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 HIGH ST STE 101",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078601010",
            "telephone_number": "973-862-4297",
            "fax_number": "973-327-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 HIGH ST STE 101",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078601010",
            "telephone_number": "973-862-4297",
            "fax_number": "973-327-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS ADDICTION AND BEHAVIORAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-20",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "GANON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "973-862-4297",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NJ",
            "license": "25MB05783900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rakesh K Garg, M.D.
• Jeffrey S Garstein, D.D.S.
• Amanda Gates, PT
• Katrina Gauthier
• Gen-Tel Medicine, LLC
• Mallory George
• Dhairyasheel Ghosalkar
• Kelsey Lynne Giannone, LPC
• Thomas William Gilfillan, DC
• Taylor Glasser

• Addiction Medicine (Family Medicine) Physician in Newton, NJ
• Providers in Newton, NJ by specialty
• Addiction Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.