Provider Demographics
NPI:1316087026
Name:ALBERTO, ALBERTO, GABRIEL & JIMENEZ MEDICAL ASSOCIATES, P.A.
Entity type:Organization
Organization Name:ALBERTO, ALBERTO, GABRIEL & JIMENEZ MEDICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:DECENA
Authorized Official - Last Name:ALBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-240-0404
Mailing Address - Street 1:25 MULE RD
Mailing Address - Street 2:BUILDING A
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5035
Mailing Address - Country:US
Mailing Address - Phone:732-240-0404
Mailing Address - Fax:732-244-3555
Practice Address - Street 1:25 MULE RD
Practice Address - Street 2:BUILDING A
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5035
Practice Address - Country:US
Practice Address - Phone:732-240-0404
Practice Address - Fax:732-244-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03142800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ148982Medicare UPIN