Provider Demographics
NPI:1609955756
Name:KAHN, MARC LESLIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:LESLIE
Last Name:KAHN
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 1:2201 CHAPEL AVE W
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2048
Mailing Address - Country:US
Mailing Address - Phone:856-663-7080
Mailing Address - Fax:856-675-3388
Practice Address - Street 1:2201 CHAPEL AVE W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2048
Practice Address - Country:US
Practice Address - Phone:856-663-7080
Practice Address - Fax:856-675-3388
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA43061207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0423977000OtherAMERIHEALTH
F01655OtherHEALTHNET
1002478OtherHORIZON
914754OtherUNITED HEALTH CARE
NJ4589505Medicaid
P875288OtherOXFORD
4274455OtherAETNA
P875288OtherOXFORD
NJ4589505Medicaid