Matthew Gruen Marin, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

25MA06092200 Issued in NJ

Practice address

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000

Phone

(973) 972-0037

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083649677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000",
            "telephone_number": "973-972-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "MATTHEW",
        "middle_name": "GRUEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA06092200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6272606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alfred V Marcinkowski III, MD
• Steven Matthew Marcus, MD
• Maria L. Varisco-Rogers Charter School
• Lauren Marici, MD
• Marie C Friedman JD LCSW Lcadc LLC
• Lori Marino, PA
• Marion P. Thomas Charter High School
• Mark Granata, DPM
• Mark Lister, M.D., PA
• Mark Pollack OD PA

• Pulmonary Disease Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Pulmonary Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.