OrganizationActive
Advanced Gastroenterology, PA
NPI 1164739447 · Gastroenterology Physician · West Orange, NJ
Provider details
- NPI number
- 1164739447
- Entity type
- Organization
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Glen Mogan, Owner(973) 731-8686
- License
- 25MA037333 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
741 Northfield Avenue
Suite 204
West Orange, NJ 07052
Phone: (973) 731-8686
Fax: (973) 731-1911
Approximate (ZIP-level) locationGet directions
Mailing address
741 Northfield Avenue
West Orange, NJ 07052
Registry dates
- Enumerated
- 2010-09-08
- Last updated
- 2010-09-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.