1205910890 NPI number — HUNTERDON ENDOCRINOLOGY AND DIABETES

Table of content: ARIK WARREN GOHL LMP (NPI 1972728434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205910890 NPI number — HUNTERDON ENDOCRINOLOGY AND DIABETES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUNTERDON ENDOCRINOLOGY AND DIABETES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1205910890
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
121 STATE ROUTE 31
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
FLEMINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08822-5744
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-788-8111
Provider Business Mailing Address Fax Number:
908-788-8180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
121 STATE ROUTE 31
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
FLEMINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08822-5744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-788-8111
Provider Business Practice Location Address Fax Number:
908-788-8120
Provider Enumeration Date:
10/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RYAN
Authorized Official First Name:
WANDA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
908-788-8111

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MA67670 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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