Provider Demographics
NPI:1225026834
Name:POPKIN, MARK (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:POPKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 JAMES ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6392
Mailing Address - Country:US
Mailing Address - Phone:973-993-1433
Mailing Address - Fax:973-993-1176
Practice Address - Street 1:261 JAMES ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6392
Practice Address - Country:US
Practice Address - Phone:973-993-1433
Practice Address - Fax:973-993-1176
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ57078207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P0712686Medicare ID - Type Unspecified
F18686Medicare UPIN