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Individual

CHRISTOPHER S. MARENGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 2ND ST, LAKEWOOD, NJ 08701
(732) 363-6655
(732) 363-6656
Mailing address
400 DEFIANCE AVE, GALLUP, NM 87301-5725
(540) 797-9779

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101245636
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA08897800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992949390
VA
05
Q017474
TN
Enumeration date
04/29/2009
Last updated
11/18/2019
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