Mabagos, Jerry D

Mabagos, Jerry D is an individual health care provider with primary practice located at 34 Machester Ave, Suite 201 , Forked River NJ 08731-1366. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Mabagos, Jerry D can be contacted via phone (609) 242-5041.

Contact Information

Primary practice address
34 Machester Ave, Suite 201 Forked River NJ 08731-1366
Fax: (609) 489-4835
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MA66825 New Jersey

Profile Details

NPI number 1164458451
LBN Legal business name Mabagos, Jerry D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2006
Last updated Mar 16th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164458451 NPPES
New Jersey MEDICAID 8092800

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