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Marlie Gabrielle Doriston

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1945 State Route 33, Neptune, NJ 07753-4859

PECOS Enrollment

This provider is enrolled in PECOS as MARLIE DORISTON.

Based on the most recent information from CMS, provider Marlie Gabrielle Doriston is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1780157966
Provider Type
Individual
Full Name
Doriston, Marlie Gabrielle
Credential
PA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/9/2019
Last Updated
3/21/2025

Contact Information

Practice Location

1945 State Route 33, Neptune, NJ 07753-4859

(732) 776-4135

Unlisted Fax

Mailing Location

331 Newman Springs Rd, Bldg 2, Ste 220, Red Bank, NJ 07701-5688

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 25MP00902800 New Jersey
Code 2255A2300X	Description Specialist/Technologist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License RT007541 Pennsylvania

Marlie Gabrielle Doriston

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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