Organization
MARLBORO GASTROENTEROLOGY RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN CHARLES WEINER MD (PRESIDENT)
(732) 972-6996
Entity
Organization
Contact information
Practice address
50 FRANKLIN LN, SUITE 201, MANALAPAN, NJ 07726-2773
(732) 972-6996
(732) 972-8610
Mailing address
50 FRANKLIN LN, SUITE 201, MANALAPAN, NJ 07726-2773
(732) 972-6996
(732) 972-8610
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
24114
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7519401
—
NJ
Enumeration date
05/09/2006
Last updated
07/30/2007
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