Provider Demographics
NPI:1336298629
Name:COASTAL GASTROENTEROLOGY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:COASTAL GASTROENTEROLOGY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:WINZELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-840-0067
Mailing Address - Street 1:PO BOX 1783
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-1067
Mailing Address - Country:US
Mailing Address - Phone:732-840-0067
Mailing Address - Fax:
Practice Address - Street 1:525 JACK MARTIN BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7737
Practice Address - Country:US
Practice Address - Phone:732-840-0067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ036315Medicare ID - Type Unspecified