Provider Demographics
NPI:1669468575
Name:MARK D MESKIN PROFESSIONAL ASSN
Entity Type:Organization
Organization Name:MARK D MESKIN PROFESSIONAL ASSN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:MESKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-349-5719
Mailing Address - Street 1:9 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6425
Mailing Address - Country:US
Mailing Address - Phone:732-349-5719
Mailing Address - Fax:732-349-5685
Practice Address - Street 1:9 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6425
Practice Address - Country:US
Practice Address - Phone:732-349-5719
Practice Address - Fax:732-349-5685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00088700213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0467270001Medicare NSC
T44825Medicare UPIN
NJ119086Medicare PIN