Jordan, Mark Louis

Jordan, Mark Louis is an individual health care provider with primary practice located at 90 Bergen St Doc 2300, Newark NJ 07103-2425. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Jordan, Mark Louis can be contacted via phone (973) 972-2888.

Contact Information

Primary practice address
90 Bergen St Doc 2300 Newark NJ 07103-2425
Phone: (973) 972-2888
Fax: (973) 972-2892
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 25MA07557800 New Jersey

Profile Details

NPI number 1831121607
LBN Legal business name Jordan, Mark Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Aug 21st, 2009 - about 15 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 1831121607 NPPES
New Jersey MEDICAID 6451608

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