Provider Demographics
NPI:1508932880
Name:MARILYN BARUIZ-CREEL PC
Entity Type:Organization
Organization Name:MARILYN BARUIZ-CREEL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARUIZ-CREEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-360-1910
Mailing Address - Street 1:499 MARLBORO RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3746
Mailing Address - Country:US
Mailing Address - Phone:732-360-1910
Mailing Address - Fax:732-679-1533
Practice Address - Street 1:499 MARLBORO RD
Practice Address - Street 2:SUITE 1
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3746
Practice Address - Country:US
Practice Address - Phone:732-360-1910
Practice Address - Fax:732-679-1533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03580300207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD18975Medicare UPIN
NJ104963Medicare ID - Type Unspecified