Provider Demographics
NPI:1659412922
Name:OCEANVIEW MEDICAL GROUP PA
Entity Type:Organization
Organization Name:OCEANVIEW MEDICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SBAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-286-9595
Mailing Address - Street 1:9 HOSPITAL DR STE C2
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6425
Mailing Address - Country:US
Mailing Address - Phone:732-286-9595
Mailing Address - Fax:732-286-0353
Practice Address - Street 1:9 HOSPITAL DR STE C2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6425
Practice Address - Country:US
Practice Address - Phone:732-286-9595
Practice Address - Fax:732-286-0353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA48725207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5062608Medicaid
NJE57210Medicare UPIN
NJ627732Medicare ID - Type Unspecified