Provider Demographics
NPI:1497846869
Name:BRICE, MARIE F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:F
Last Name:BRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIE
Other - Middle Name:FENELON
Other - Last Name:BRICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:300 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3317
Mailing Address - Country:US
Mailing Address - Phone:908-355-0664
Mailing Address - Fax:
Practice Address - Street 1:300 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3317
Practice Address - Country:US
Practice Address - Phone:908-355-0664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07919800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ096439Medicare ID - Type UnspecifiedMEDICARE NUMBER