Basic Information
| Provider Information | |||||||||
| NPI: | 1386733673 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEALT | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST | ||||||||
| Address2: | STE SW200 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8569687363 | ||||||||
| FaxNumber: | 8563564710 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 COOPER PLZ | ||||||||
| Address2: | SUITE 408 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8569687363 | ||||||||
| FaxNumber: | 8563564710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 04/11/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | MB074794 | NJ | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207X00000X | 25MB07479400 | NJ | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 010007754 00 | 01 | NJ | AMERICHOICE | OTHER | 2648579000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC/PABS | OTHER | 2604548 | 01 | NJ | UNITED HEALTH PLAN | OTHER | 3K5444 | 01 | NJ | HEALTHNET | OTHER | 41338 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 1020725940001 | 05 | PA | MEDICAID | P3722952 | 01 | NJ | OXFORD | OTHER | 0079154 | 05 | NJ | MEDICAID | 1223777 | 01 | NJ | CIGNA | OTHER | 2007127 | 01 | PA | PA BS HIGHMARK | OTHER | 3423025000 | 01 | PA | KEYSTONE/IBC | OTHER | 60022433 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 1072033/7569720 | 01 | NJ | AETNA | OTHER |