Provider Demographics
NPI:1710949276
Name:RUOFF, MARK JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:JOSEPH
Last Name:RUOFF
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 1:246 HAMBURG TURNPIKE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470
Mailing Address - Country:US
Mailing Address - Phone:973-689-6266
Mailing Address - Fax:973-689-6264
Practice Address - Street 1:246 HAMBURG TURNPIKE
Practice Address - Street 2:SUITE 305
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-689-6266
Practice Address - Fax:973-689-6264
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05339200207XS0117X
NJMA053392174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6073905Medicaid
NJ6073905Medicaid
NJ6073905Medicaid