Provider Demographics
NPI:1326228982
Name:GEORGY, MARY SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:SARAH
Last Name:GEORGY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 HWY 88 W
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3071
Mailing Address - Country:US
Mailing Address - Phone:732-458-2000
Mailing Address - Fax:732-458-4523
Practice Address - Street 1:1673 HWY 88 W
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3071
Practice Address - Country:US
Practice Address - Phone:732-458-2000
Practice Address - Fax:732-458-4523
Is Sole Proprietor?:No
Enumeration Date:2007-11-11
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08328100207R00000X
PAMD432141207R00000X
NJ25MA0832810207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0168378Medicaid
NJ0168378Medicaid
NJ126958XPFMedicare PIN