Provider Demographics
NPI:1942795802
Name:MARDEN, KYLE RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:RICHARD
Last Name:MARDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 HADDON AVENUE
Mailing Address - Street 2:2ND FLOOR, 266
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103
Mailing Address - Country:US
Mailing Address - Phone:856-342-2000
Mailing Address - Fax:856-757-7803
Practice Address - Street 1:401 HADDON AVENUE
Practice Address - Street 2:2ND FLOOR ROOM 266
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2000
Practice Address - Fax:856-757-7803
Is Sole Proprietor?:No
Enumeration Date:2018-06-24
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116032507390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program