Basic Information
| Provider Information | |||||||||
| NPI: | 1518067297 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRATZ | ||||||||
| FirstName: | IRWIN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST STE SW200 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563564924 | ||||||||
| FaxNumber: | 8563564710 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 COOPER PLZ | ||||||||
| Address2: | COOPER ANESTHESIA ASSOCIATES | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422425 | ||||||||
| FaxNumber: | 8569688239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2006 | ||||||||
| LastUpdateDate: | 03/07/2018 | ||||||||
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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 | 207L00000X | MB62170 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1138751 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 843500 | 01 | NJ | AMERIHEALTH PPO/PA BS | OTHER | 1081257 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 0876198000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 2455005 | 05 | NJ | MEDICAID | 30262 | 01 | NJ | UNIVERSITY HEATH PLAN | OTHER | 010003810 | 01 | NJ | AMERICHOICE | OTHER | 0840843 | 01 | NJ | AETNA | OTHER | 2566062 | 01 | NJ | UNITED HEALTHCARE | OTHER |