Active NPI
Keith M Gottesdiener, M.D.
- Infectious Disease Physician
- Rahway, NJ
National Provider Identifier
1821150376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 52203
- Practice address
- MRL-126 East Lincoln Ave.
Rahway, NJ 07065 - Phone
- (732) 594-4217
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 52203 | MA | Primary |
Addresses
Primary practice location
MRL-126 East Lincoln Ave.
Rahway, NJ 07065
Mailing address
19 Rock Hill LN
Scarsdale, NY 10583-1026
Phone (732) 594-4217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52203 | MA | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251417600000",
"number": "1821150376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 ROCK HILL LN",
"city": "SCARSDALE",
"state": "NY",
"postal_code": "105831026",
"telephone_number": "732-594-4217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MRL-126 EAST LINCOLN AVE.",
"city": "RAHWAY",
"state": "NJ",
"postal_code": "07065",
"telephone_number": "732-594-4217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTESDIENER",
"first_name": "KEITH",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2009-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "MA",
"license": "52203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rahway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.