Provider Demographics
NPI:1356319180
Name:ZUCKER, MARK J (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:ZUCKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 824967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-4967
Mailing Address - Country:US
Mailing Address - Phone:800-941-8933
Mailing Address - Fax:732-918-8940
Practice Address - Street 1:21 PERRY ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-9446
Practice Address - Country:US
Practice Address - Phone:973-984-2222
Practice Address - Fax:973-984-2122
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2024-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJNJMA45124207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0333808Medicaid
NJD16485Medicare UPIN