Provider Demographics
NPI:1497722060
Name:SOFFER, MARK J (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:SOFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PHEASANT RUN
Mailing Address - Street 2:SUITE 128
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3439
Mailing Address - Country:US
Mailing Address - Phone:215-860-3344
Mailing Address - Fax:215-860-8950
Practice Address - Street 1:1 UNION ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-4183
Practice Address - Country:US
Practice Address - Phone:609-890-6677
Practice Address - Fax:609-890-7292
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024817E207RI0011X
NJ25MA04412300207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0766704Medicaid
PA0300863000OtherKEYSTONE
NJ060045609OtherRAILROAD MEDICARE
NJ0054974000OtherAMERIHEALTH
PA0766704Medicaid
PA423703OtherPENNSYLVANIA BLUE SHIELD
NJ033779OtherPENNSYLVANIA BLUE SHIELD
NJ033779OtherPENNSYLVANIA BLUE SHIELD
NJ0766704Medicaid
NJC57912Medicare UPIN
NJ0054974000OtherAMERIHEALTH