Provider Demographics
NPI:1447410014
Name:BARANSKI, GREGG MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:GREGG
Middle Name:MICHAEL
Last Name:BARANSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COMPASS CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6104
Mailing Address - Country:US
Mailing Address - Phone:973-464-6499
Mailing Address - Fax:
Practice Address - Street 1:401 YOUNG AVE STE 275
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3141
Practice Address - Country:US
Practice Address - Phone:856-291-8670
Practice Address - Fax:856-291-8671
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09248900208C00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0479870Medicaid