Gershenbaum, Mark R
Gershenbaum, Mark R is an individual health care provider with primary practice located at 901 West Main St , Freehold NJ 07728. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gershenbaum, Mark R can be contacted via phone (732) 294-2666.Contact Information
Primary practice address
901 West Main St
Freehold NJ 07728
Phone: (732) 294-2666
Fax: (732) 431-8267
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25MB04672200 | New Jersey |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 25MB04672200 | New Jersey |
Profile Details
| NPI number | 1982665782 |
|---|---|
| LBN Legal business name | Gershenbaum, Mark R |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982665782 | NPPES |
| New Jersey | MEDICAID | 5453101 | |
| New Jersey | Other | P00153530 |
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