Provider Demographics
NPI:1487648457
Name:ENGEL, MARK L (MD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:L
Last Name:ENGEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:733 N BEERS ST
Mailing Address - Street 2:STE U4
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1528
Mailing Address - Country:US
Mailing Address - Phone:732-739-0707
Mailing Address - Fax:732-739-6722
Practice Address - Street 1:733 N BEERS ST
Practice Address - Street 2:STE U4
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1528
Practice Address - Country:US
Practice Address - Phone:732-739-0707
Practice Address - Fax:732-739-6722
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NJMA29390207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2914603Medicaid
NJ2914603Medicaid
NJ527403Medicare ID - Type Unspecified