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General NPI Number Information
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NPI Number | 1396782082
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Entity Type | Organization
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Legal Business Name | MERCER GASTROENTEROLOGY PC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 416 BELLEVUE AVE SUITE 101
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City | TRENTON
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State | NJ
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Zip | 08618-4513
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Country | US
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Telephone | 609-394-8844
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Fax | 609-695-5141
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Provider Business Mailing Address
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Address Line | 416 BELLEVUE AVE SUITE 101
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City | TRENTON
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State | NJ
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Zip | 08618-4500
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Country | US
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Telephone | 609-394-8844
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Fax | 609-695-5141
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEOBEL A MARIN
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Credential | M.D
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Telephone | 609-394-8844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MA26199
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License Number State | NJ
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