Provider Demographics
NPI:1376729046
Name:FLOOD, MARK JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JAMES
Last Name:FLOOD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:140 PROSPECT AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2255
Mailing Address - Country:US
Mailing Address - Phone:201-488-6543
Mailing Address - Fax:201-488-6916
Practice Address - Street 1:140 PROSPECT AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2255
Practice Address - Country:US
Practice Address - Phone:201-488-6543
Practice Address - Fax:201-488-6916
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-12
Last Update Date:2008-01-23
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Provider Licenses
StateLicense IDTaxonomies
NJ2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ675354CTYMedicare PIN