Basic Information
| Provider Information | |||||||||
| NPI: | 1154379881 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRIM | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1702 QUEEN ANNE LN | ||||||||
| Address2: | |||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087533374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094894648 | ||||||||
| FaxNumber: | 7083422517 | ||||||||
| Practice Location | |||||||||
| Address1: | 34 MANCHESTER AVE STE 105 | ||||||||
| Address2: | |||||||||
| City: | FORKED RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087311366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094894846 | ||||||||
| FaxNumber: | 6094894651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 12/12/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | MA51879 | NJ | N | Allopathic & Osteopathic Physicians | General Practice | 174400000X | MA51879 | NJ | Y | Other Service Providers | Specialist |
No ID Information.