Wallen, Mark

Wallen, Mark is an individual health care provider with primary practice located at 42 Laurel Rd E Suite # 3610, Stratford NJ 08084-1354. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Wallen, Mark can be contacted via phone (856) 482-9000.

Contact Information

Primary practice address
42 Laurel Rd E Suite # 3610 Stratford NJ 08084-1354
Phone: (856) 482-9000
Fax: (856) 482-1159
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MA03512400 New Jersey
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X MA03512400 New Jersey

Profile Details

NPI number 1366416901
LBN Legal business name Wallen, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Nov 18th, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366416901 NPPES
New Jersey MEDICAID 7596707

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