Provider Demographics
NPI:1932146255
Name:LAUFGRABEN, MARC J (MD, MBA)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:J
Last Name:LAUFGRABEN
Suffix:
Gender:M
Credentials:MD, MBA
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Mailing Address - Street 1:200 HYGEIA DR STE 2300
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:856-342-2312
Mailing Address - Fax:856-968-0735
Practice Address - Street 1:4735 OGLETOWN STANTON RD
Practice Address - Street 2:MAP 2 STE 3201
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2094
Practice Address - Country:US
Practice Address - Phone:302-623-4323
Practice Address - Fax:856-968-0735
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08922800207RE0101X
RIMD09982207RE0101X
DEC10012170207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7006688Medicaid
RI7006688Medicaid