Provider Demographics
NPI:1770524274
Name:GORIN, RISA JILL (DO)
Entity type:Individual
Prefix:DR
First Name:RISA
Middle Name:JILL
Last Name:GORIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2026 BRIGGS RD STE B
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4602
Mailing Address - Country:US
Mailing Address - Phone:609-288-6884
Mailing Address - Fax:609-667-7103
Practice Address - Street 1:225 HWY 35 STE 208
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5919
Practice Address - Country:US
Practice Address - Phone:732-747-5500
Practice Address - Fax:732-747-1212
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB07615100207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI21465Medicare UPIN
NJ085037Medicare PIN
NJ085549Medicare ID - Type Unspecified