Provider Demographics
NPI:1255332177
Name:MAGSINO, VICENTE MARTINEZ JR (MD)
Entity Type:Individual
Prefix:DR
First Name:VICENTE
Middle Name:MARTINEZ
Last Name:MAGSINO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:65 LACEY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2985
Mailing Address - Country:US
Mailing Address - Phone:732-350-0404
Mailing Address - Fax:732-350-2001
Practice Address - Street 1:65 LACEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2985
Practice Address - Country:US
Practice Address - Phone:732-350-0404
Practice Address - Fax:732-350-2001
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06928200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8059209Medicaid
NJ8059209Medicaid
NJ028517N9NMedicare ID - Type Unspecified