Provider Demographics
NPI:1316307283
Name:NJ DIGESTIVE HEALTH MD PC
Entity type:Organization
Organization Name:NJ DIGESTIVE HEALTH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANU
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMPAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-281-3590
Mailing Address - Street 1:10 WHITE ROCK TER
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1645
Mailing Address - Country:US
Mailing Address - Phone:718-227-1282
Mailing Address - Fax:732-281-0054
Practice Address - Street 1:1340 RTE 34
Practice Address - Street 2:STE B
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-1947
Practice Address - Country:US
Practice Address - Phone:718-227-1282
Practice Address - Fax:732-281-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty