Provider Demographics
NPI:1265693915
Name:MARK ENDE, DO, PA
Entity type:Organization
Organization Name:MARK ENDE, DO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-244-2700
Mailing Address - Street 1:1228 ROUTE 37 W
Mailing Address - Street 2:SUITE 6
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4811
Mailing Address - Country:US
Mailing Address - Phone:732-244-2700
Mailing Address - Fax:732-244-7666
Practice Address - Street 1:1228 ROUTE 37 W
Practice Address - Street 2:SUITE 6
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4811
Practice Address - Country:US
Practice Address - Phone:732-244-2700
Practice Address - Fax:732-244-7666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty