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Organization

BRICKTOWN MEDICAL GROUP PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARTIN RISS DO (PRESIDENT)
(732) 458-0300
Entity
Organization

Contact information

Practice address
34 LANES MILL RD, BRICK, NJ 08724
(732) 458-0300
(732) 458-8449
Mailing address
34 LANES MILL RD, BRICK, NJ 08724
(732) 458-0300
(732) 458-8449

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
09/14/2006
Last updated
02/23/2011
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