Provider Demographics
NPI:1235420696
Name:CENTRAL JERSEY NEWBORN CARE
Entity Type:Organization
Organization Name:CENTRAL JERSEY NEWBORN CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:908-829-3465
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-0074
Mailing Address - Country:US
Mailing Address - Phone:908-829-3465
Mailing Address - Fax:908-359-4036
Practice Address - Street 1:43 RED FOX CT
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-1722
Practice Address - Country:US
Practice Address - Phone:908-829-3465
Practice Address - Fax:908-359-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA50514208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE58652Medicare UPIN