Provider Demographics
NPI:1700081536
Name:MORREALE, GINJA M (MD)
Entity Type:Individual
Prefix:
First Name:GINJA
Middle Name:M
Last Name:MORREALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GINJA
Other - Middle Name:B
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:514 BANGS AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6902
Mailing Address - Country:US
Mailing Address - Phone:732-774-0200
Mailing Address - Fax:732-774-1019
Practice Address - Street 1:514 BANGS AVE
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-6902
Practice Address - Country:US
Practice Address - Phone:732-774-0200
Practice Address - Fax:732-774-1019
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08265200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ116122UUGMedicare PIN