Provider Demographics
NPI:1871536474
Name:DRASCHER, GARY A (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:A
Last Name:DRASCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 REHILL AVE
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2500
Mailing Address - Country:US
Mailing Address - Phone:908-927-8994
Mailing Address - Fax:908-927-8995
Practice Address - Street 1:30 REHILL AVE
Practice Address - Street 2:SUITE 3300
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2500
Practice Address - Country:US
Practice Address - Phone:908-927-8994
Practice Address - Fax:908-927-8995
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA493782086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0734403Medicaid
445950BC4Medicare PIN
C54780Medicare UPIN