Provider Demographics
NPI:1124255906
Name:MARLBORO DIGESTIVE HEALTH PA
Entity type:Organization
Organization Name:MARLBORO DIGESTIVE HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-972-6996
Mailing Address - Street 1:50 FRANKLIN LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-2773
Mailing Address - Country:US
Mailing Address - Phone:732-972-6996
Mailing Address - Fax:732-972-8610
Practice Address - Street 1:50 FRANKLIN LN
Practice Address - Street 2:SUITE 201
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-2773
Practice Address - Country:US
Practice Address - Phone:732-972-6996
Practice Address - Fax:732-972-8610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty