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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144259425 NPPES
New York MEDICAID 01113533
New York MEDICAID 3396100

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