Provider Demographics
NPI:1154553063
Name:GERIATRIC TREATMENT RESOURCES LLC
Entity type:Organization
Organization Name:GERIATRIC TREATMENT RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRITI
Authorized Official - Middle Name:S
Authorized Official - Last Name:GUJAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-744-5754
Mailing Address - Street 1:12 BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7955
Mailing Address - Country:US
Mailing Address - Phone:609-744-5754
Mailing Address - Fax:
Practice Address - Street 1:123 FRANKLIN CORNER RD STE 204
Practice Address - Street 2:
Practice Address - City:LAWRENCE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08648-2526
Practice Address - Country:US
Practice Address - Phone:609-730-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8213101Medicaid