Provider Demographics
NPI:1790124394
Name:MARRIOTT, CHRISTINE RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:RYAN
Last Name:MARRIOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1445 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3834
Mailing Address - Country:US
Mailing Address - Phone:609-587-6661
Mailing Address - Fax:609-587-8503
Practice Address - Street 1:1445 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3834
Practice Address - Country:US
Practice Address - Phone:609-587-6661
Practice Address - Fax:609-587-8503
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455944207Q00000X
NJ25MA09844500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine