NPIMap

Organization Active NPI

Marlboro Gastroenterology Radiology PC

  • Multi-Specialty Clinic/Center
  • Manalapan, NJ
National Provider Identifier
1629027503
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
24114 Issued in NJ
Legal business name
MARLBORO GASTROENTEROLOGY RADIOLOGY PC
Practice address
50 Franklin LN
Suite 201
Manalapan, NJ 07726-2773
Phone
(732) 972-6996
Fax
(732) 972-8610
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Authorized official

Name
Dr. Brian Charles Weiner, MD
Title
President
Phone
(732) 972-6996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 24114 NJ Primary

Addresses

Primary practice location

50 Franklin LN
Suite 201
Manalapan, NJ 07726-2773

Mailing address

50 Franklin LN
Suite 201
Manalapan, NJ 07726-2773
Phone (732) 972-6996

Other identifiers 1

IdentifierTypeStateIssuer
7519401MedicaidNJ

National Provider Directory

National Provider Directory

Locations

502 Candlewood Cmns
#C
Howell, NJ 07731
Phone (732) 905-5888

502 Candlewood Cmns
Howell, NJ 07731
Phone (732) 363-3668

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1629027503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 FRANKLIN LN",
            "address_2": "SUITE 201",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077262773",
            "telephone_number": "732-972-6996",
            "fax_number": "732-972-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 FRANKLIN LN",
            "address_2": "SUITE 201",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077262773",
            "telephone_number": "732-972-6996",
            "fax_number": "732-972-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLBORO GASTROENTEROLOGY RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-972-6996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NJ",
            "license": "24114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7519401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.