GARY I GORODOKIN (NPI# 1619996774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619996774 |
| Entity Type | Individual |
| Full Name | GARY I GORODOKIN |
| Credential | MD |
| Practice Address |
24-07 A Broadway Fair Lawn NJ 07410 |
| Mailing Address |
34 Knights Court Upper Saddle River NJ 07458 |
| Practice Telephone | 2017917760 |
| Practice Fax Number | 2017917746 |
| Mailing Telephone | 2017917760 |
| Mailing Fax Number | 2017917746 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-03-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
182511 | NY | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MA06159800 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | AETNA | 5596271 | 01 |
| OXFORD | P698453 | 01 | |
| NY | EMPIRE | 758683 | 01 |
| GHI | 2504592 | 01 | |
| NY | 183559 | ELDERPLAN | 01 |
| NJ | HEALTH NET | 0K7399 | 01 |
| NJ | 6878105 | 05 | |
| NJ | EMPIRE | 3V7781 | 01 |
| Street Address |
24-07 A BROADWAY |
| City | FAIR LAWN |
| State | NJ |
| Zip Code | 07410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669093316 | Sheila Robinson-kiss LLC | Counselor | 0-178 Tunbridge Road, Fair Lawn, NJ 07410 | 2020-05-05 |
| 1750902813 | Pine Group LLC | Point of Service | 0-39 Pine Ave, Fair Lawn, NJ 07410 | 2020-04-29 |
| 1073133153 | Maria Jidriska Myers | Nurse Practitioner | 23-00 Nj-208, Fair Lawn, NJ 07410 | 2020-04-20 |
| 1508350869 | Jill Marie Deperi | Counselor | 22-08 Route 208 South, Fair Lawn, NJ 07410 | 2018-06-20 |
| 1952895419 | Laurel Olson | Counselor | Care Plus Nj Children and Family Services, 17-07 Romaine Street, Fair Lawn, NJ 07410 | 2018-06-19 |
| 1851896583 | Janelle Frazier | Social Worker | Care Plus New Jersey, 17-07 Romaine St, Fair Lawn, NJ 07410 | 2018-03-26 |
| 1457876260 | Daniella Suric | Behavioral Analyst | 2-08 Morlot Avenue, Fair Lawn, NJ 07410 | 2017-08-14 |
| 1912453549 | Marcia Gurfield | Social Worker | 33-03 Ryan Road, Fair Lawn, NJ 07410 | 2016-09-01 |
| 1417330721 | The Arc of Bergen and Passaic Counties, Inc | Day Training, Developmentally Disabled Services | 17-03a Broadway, Fair Lawn, NJ 07410 | 2015-07-06 |
| 1275914228 | Julius Iratagotia | Occupational Therapist | 0-53 26th St, Fair Lawn, NJ 07410 | 2015-06-16 |
| Find all providers in zip 07410 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205813391 | Ramesh C Gupta | Internal Medicine | 15-01 Broadway, Suite 28, Fair Lawn, NJ 07410-6003 | 2005-12-29 |
| 1497812796 | Jonathan Resnick | Internal Medicine | 31-00 Broadway, Fair Lawn, NJ 07410-3963 | 2007-01-03 |
| 1801853031 | Kuchipudi Bapineedu | Internal Medicine | 15-01 Broadway, Ste 22, Fair Lawn, NJ 07410 | 2006-05-01 |
| 1477522712 | Donald Harold Kutner | Internal Medicine | 15-01 Broadway, Suite 34, Fair Lawn, NJ 07410-6003 | 2006-03-17 |
| 1790757870 | Jeffrey Lefkowitz | Internal Medicine | 11-26 Saddle River Rd, Fair Lawn, NJ 07410-5634 | 2006-02-03 |
| 1386622264 | North Jersey Gi Associates,pa | Internal Medicine | 15-01 Broadway, Suite # 28, Fair Lawn, NJ 07410-6003 | 2006-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144843483 | Alok Goyal, M.d. | Internal Medicine | 2509 Park Ave Ste 1a, South Plainfield, NJ 07080-5300 | 2020-05-21 |
| 1386111524 | Premier Gastroenterology of Hamilton | Internal Medicine | 2271 Route 33 Ste 110, Hamilton, NJ 08690-1749 | 2018-10-25 |
| 1063908739 | Hemorrhoids Usa Pa | Internal Medicine | 300b Princeton Hightstown Rd Ste 206a, East Windsor, NJ 08520-1400 | 2018-07-06 |
| 1275038499 | Srinivas Madane LLC | Internal Medicine | 33 Ridgeline Dr, Long Valley, NJ 07853-3376 | 2018-03-28 |
| 1043726821 | Gi Endoscopy Practice LLC | Internal Medicine | 44 State Rt 23 Ste 7, Riverdale, NJ 07457-1603 | 2017-12-15 |
| 1326553033 | Richard G Pizzano | Internal Medicine | 135 Bloomfield Ave Ste K, Bloomfield, NJ 07003-5902 | 2017-12-05 |
| 1609387109 | Medigest Healthcare Services LLC | Internal Medicine | 1030 Saint Georges Ave Ste 103a, Avenel, NJ 07001-1330 | 2017-10-24 |
| 1306372578 | Advocare Allied Gastrointestinal Associates | Internal Medicine | 401 Route 73 N, Bldg 10, Ste 320, Lake Center Executive Park, Marlton, NJ 08053 | 2017-05-10 |
| 1144779133 | East Brunswick Endoscopy Center Inc | Internal Medicine | 385 Highway 18, East Brunswick, NJ 08816-5703 | 2016-10-01 |
| 1841651965 | Kovil Ramaswamy Md Pa | Internal Medicine | 534 Avenue E Ste 1-a, Bayonne, NJ 07002-3987 | 2016-03-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.