Active NPI
Middlesex Monmouth Gastroenterology
- Anesthesiology Physician
- Freehold, NJ
National Provider Identifier
1780970749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- MIDDLESEX MONMOUTH GASTROENTEROLOGY
- Practice address
- 222 Schanck Rd
Suite 100
Freehold, NJ 07728-3068 - Phone
- (732) 577-1999
- Fax
- (732) 845-5356
- NPI assigned
- Jun 28, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Debard, MPA
- Title
- Administrator
- Phone
- (732) 577-1999
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
222 Schanck Rd
Suite 100
Freehold, NJ 07728-3068
Mailing address
222 Schanck Rd
Suite 100
Freehold, NJ 07728-3068
Phone (732) 577-1999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071151 | Other | NJ | MEDICARE PTAN |
Other names 1
- MMG Anesthesia Services
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Freehold, NJ
- NPI 1710982210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1309219200000",
"number": "1780970749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 SCHANCK RD",
"address_2": "SUITE 100",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077283068",
"telephone_number": "732-577-1999",
"fax_number": "732-845-5356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 SCHANCK RD",
"address_2": "SUITE 100",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077283068",
"telephone_number": "732-577-1999",
"fax_number": "732-845-5356"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDDLESEX MONMOUTH GASTROENTEROLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2011-06-28",
"last_updated": "2011-06-28",
"status": "A",
"authorized_official_last_name": "DEBARD",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "732-577-1999",
"authorized_official_credential": "MPA"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "071151",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MMG Anesthesia Services",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Freehold, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.