Decotiis, Mark Anthony

Decotiis, Mark Anthony is an individual health care provider with primary practice located at 721 N Beers St Ste. 2C, Holmdel NJ 07733-1518. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Decotiis, Mark Anthony can be contacted via phone (732) 888-1717.

Contact Information

Primary practice address
721 N Beers St Ste. 2C Holmdel NJ 07733-1518
Fax: (732) 888-2101
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X MD02381 New Jersey

Profile Details

NPI number 1851360036
LBN Legal business name Decotiis, Mark Anthony
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Mar 17th, 2014 - about 10 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 1851360036 NPPES
Other 10654598 CAQH
Other 2K6416 CAQH
Other P1093167 CAQH
Other PJ3001 CAQH

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