Yanto Meiyer Gultom, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA07450700 Issued in NJ

Practice address

403 Towne Centre Dr
Hillsborough, NJ 08844-4698

Phone

(908) 428-4840

Fax

(908) 382-3288

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alliance for Better Care, P.C.

  • Family Medicine Physician
  • Medford, NJ
  • NPI 1740352459
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1851444228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 WILLOCKS CIR",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088737462",
            "telephone_number": "732-322-5223",
            "fax_number": "908-382-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 TOWNE CENTRE DR",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088444698",
            "telephone_number": "908-428-4840",
            "fax_number": "908-382-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULTOM",
        "first_name": "YANTO",
        "middle_name": "MEIYER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07450700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory D Hirsch MD LLC
• Joanne Griesser, LPN
• Rebecca Grossman, CADC
• Guardian Community Services LLC
• Renukamba N. Gubbi, M.D.
• Gynecological Solutions PA
• Roger Haas, MD
• Amanda Nicole Haase, MABA
• Brenda L. Habenicht-Braid, O.D.
• Leila Halwani, LCSW

• Internal Medicine Physician in Hillsborough, NJ
• Providers in Hillsborough, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.