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General NPI Number Information
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NPI Number | 1982924080
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Entity Type | Organization
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Legal Business Name | COASTAL ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 175 GUNNING RIVER RD
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City | BARNEGAT
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State | NJ
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Zip | 08005-1436
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Country | US
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Telephone | 609-654-6525
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Fax | 609-981-9078
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Provider Business Mailing Address
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Address Line | 175 GUNNING RIVER RD BUILDING A, UNIT 4
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City | BARNEGAT
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State | NJ
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Zip | 08005-1436
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Country | US
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Telephone | 609-654-6525
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Fax | 609-981-9078
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Authorized Official
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Title or Position | MD
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Name | NEAL J WINZELBERG
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Credential |
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Telephone | 609-654-6525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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