Provider Demographics
NPI:1154352698
Name:FORESTER, GARY P (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:P
Last Name:FORESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PLAINSBORO ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-0000
Mailing Address - Country:US
Mailing Address - Phone:609-853-7272
Mailing Address - Fax:609-853-7271
Practice Address - Street 1:5 PLAINSBORO ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-0000
Practice Address - Country:US
Practice Address - Phone:609-853-7272
Practice Address - Fax:609-853-7271
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04176000207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ204630001Medicaid
NJ204630001Medicaid
NJB18881Medicare UPIN