Kirschenbaum, Mark David
Kirschenbaum, Mark David is an individual health care provider with primary practice located at 104 Chestnut St , Ridgewood NJ 07450-2502. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Kirschenbaum, Mark David can be contacted via phone (201) 670-4664.Contact Information
Primary practice address
104 Chestnut St
Ridgewood NJ 07450-2502
Phone: (201) 670-4664
Fax: (201) 670-8007
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MA04933400 | New Jersey |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25MA04933400 | New Jersey |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 155240 | New York |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 155240 | New York |
Profile Details
| NPI number | 1144259425 |
|---|---|
| LBN Legal business name | Kirschenbaum, Mark David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Jan 24th, 2011 - about 13 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 | 1144259425 | NPPES |
| New York | MEDICAID | 01113533 | |
| New York | MEDICAID | 3396100 |
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