SPARTA GASTROENTEROLOGY LLC NPI 1245424696

NPI Information

NPI: 1245424696
Provider Name: SPARTA GASTROENTEROLOGY LLC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
376 LAFAYETTE RD
SUITE 101
SPARTA, NJ
ZIP 07871
Phone: (973) 579-3174
Get Directions

SPARTA GASTROENTEROLOGY LLC is a gastroenterology internal medicine in Sparta, NJ. The provider is 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. SPARTA GASTROENTEROLOGY LLC NPI is 1245424696. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

376 LAFAYETTE RD
SUITE 101
SPARTA, NJ
ZIP 07871
Phone: (973) 579-3174
Fax: (973) 579-2961

The provider's authorized official is Dmitry Mysh .
The authorized official title is Md Owner and has the following contact phone number (973) 579-3174.

The enumeration date for this NPI number is 8/29/2007 and was last updated on 12/3/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RG0100X	Internal Medicine	Gastroenterology	25MA065097	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	116954	MEDICARE PIN	NEW JERSEY
2	8503206	MEDICAID	NEW JERSEY
3	H02847	MEDICARE UPIN	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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