Cgganjhos LLC

Organization Active NPI Clinic/Center · Park Ridge, NJ

NPI 1649019258 · NPPES record last updated May 22, 2024

Key facts

NPI
1649019258
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
Legal business name
CGGANJHOS LLC
Practice address
8 Glenbrook Dr
Park Ridge, NJ 07656-1808
Phone
(845) 596-3760
NPI assigned
May 22, 2024
Organization subpart
No

Authorized official

Name
Erik Svensson NPI 1770879371
Title
MD
Phone
(845) 596-3760

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240530000093 NJ Part B Supplier - Clinic/Group Practice 4981046489 Receives reassigned benefits from 1 practitioner
Practice locations: Park Ridge, NJ; Hackensack, NJ

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Yes

Addresses

Primary practice location

8 Glenbrook Dr
Park Ridge, NJ 07656-1808

Mailing address

8 Glenbrook Dr
Park Ridge, NJ 07656-1808

Other providers in Park Ridge, NJ

All providers in Park Ridge, NJ · Clinic/Center in New Jersey

Sources for this page

Verify at the official NPI Registry.