Provider Demographics
NPI:1982924080
Name:COASTAL ENDOSCOPY CENTER, LLC
Entity type:Organization
Organization Name:COASTAL ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINZELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-654-6525
Mailing Address - Street 1:175 GUNNING RIVER RD
Mailing Address - Street 2:BUILDING A, UNIT 4
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1436
Mailing Address - Country:US
Mailing Address - Phone:609-654-6525
Mailing Address - Fax:609-981-9078
Practice Address - Street 1:175 GUNNING RIVER RD
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-1436
Practice Address - Country:US
Practice Address - Phone:609-654-6525
Practice Address - Fax:609-981-9078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical