Basic Information
| Provider Information | |||||||||
| NPI: | 1629076476 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARIN | ||||||||
| FirstName: | GEOBEL | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CAPITAL WAY | ||||||||
| Address2: | SUITE 487 | ||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085342521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098181900 | ||||||||
| FaxNumber: | 6098181908 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 CAPITAL WAY | ||||||||
| Address2: | SUITE 487 | ||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085342521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098181900 | ||||||||
| FaxNumber: | 6098181908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2005 | ||||||||
| LastUpdateDate: | 09/27/2012 | ||||||||
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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 | 207RG0100X | 26199 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 2549794 | 01 | NJ | AETNA | OTHER | 0081639000 | 01 | NJ | AMERIHEALTH | OTHER | 2152207 | 05 | NJ | MEDICAID | MEP058 | 01 | OXFORD | OTHER |