Individual
JERRY D MABAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 ROUTE 70 STE 1C, BRICK, NJ 08723-4022
(732) 279-6537
(732) 458-6356
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA06682500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8092800
—
NJ
Enumeration date
06/25/2006
Last updated
12/29/2025
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