Provider Demographics
NPI:1295823060
Name:SIRNINGER, MARK JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JASON
Last Name:SIRNINGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3726
Mailing Address - Country:US
Mailing Address - Phone:908-534-3411
Mailing Address - Fax:908-450-9769
Practice Address - Street 1:121 MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3726
Practice Address - Country:US
Practice Address - Phone:908-534-3411
Practice Address - Fax:908-450-9769
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00552600111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU93201Medicare UPIN