Provider Demographics
NPI:1073660635
Name:CARR, MARCUS E JR
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:E
Last Name:CARR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 WEST GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:685 HIGHWAY ROUTE 1
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:732-214-2425
Practice Address - Fax:609-580-8626
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08077400207RH0000X
VA0101038029207RH0000X
NC25483207RH0000X
PAMD428417207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0154679Medicaid
NJ122074ALJMedicare PIN
NJ0154679Medicaid