Individual
MARLIE GABRIELLE DORISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1945 STATE ROUTE 33, NEPTUNE, NJ 07753-4859
(732) 776-4135
Mailing address
331 NEWMAN SPRINGS RD, BLDG 2, STE 220, RED BANK, NJ 07701-5688
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
RT007541
PA
363A00000X
Physician Assistant
Primary
25MP00902800
NJ
Other
Enumeration date
01/09/2019
Last updated
03/21/2025
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