Provider Demographics
NPI:1376551275
Name:MAGSALIN ALBERTO, PRISCILLA (MD)
Entity Type:Individual
Prefix:DR
First Name:PRISCILLA
Middle Name:
Last Name:MAGSALIN ALBERTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRISCILLA
Other - Middle Name:
Other - Last Name:MAGSALIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 MULE RD
Mailing Address - Street 2:BUILDING A
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5035
Mailing Address - Country:US
Mailing Address - Phone:732-240-0404
Mailing Address - Fax:732-244-3555
Practice Address - Street 1:25 MULE RD
Practice Address - Street 2:BUILDING A
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5035
Practice Address - Country:US
Practice Address - Phone:732-240-0404
Practice Address - Fax:732-244-3555
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03196600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
148982OtherGROUP MEDICARE
NJ1485105Medicaid
148982OtherGROUP MEDICARE
NJ1485105Medicaid