Provider Demographics
NPI:1376659466
Name:STORCH, MARC IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:IRA
Last Name:STORCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1100 WISCOTT DRIVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822
Mailing Address - Country:US
Mailing Address - Phone:908-284-9221
Mailing Address - Fax:908-237-2366
Practice Address - Street 1:1100 WISCOTT DRIVE
Practice Address - Street 2:SUITE 106
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:908-284-9221
Practice Address - Fax:908-237-2366
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJNJ59225207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7233701Medicaid
F53485Medicare UPIN
NJ7233701Medicaid