Provider Demographics
NPI:1649268525
Name:TITI, MARK JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOSEPH
Last Name:TITI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2445 MARIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1942
Mailing Address - Country:US
Mailing Address - Phone:717-393-1365
Mailing Address - Fax:717-393-8540
Practice Address - Street 1:2445 MARIETTA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1942
Practice Address - Country:US
Practice Address - Phone:717-393-1365
Practice Address - Fax:717-393-8540
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2014-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043419L207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
23498OtherGEISINGER
PA001454732Medicaid
0466771OtherAETNA
0695883000OtherAMERIHEALTH HMO
0753481OtherBC & BS PERSONAL CHOICE
0753481OtherKEYSTONE HEALTH PLAN CENT
1518760OtherGATEWAY
02098001OtherCAPITOL BLUE CROSS
030003465OtherRAILROAD MEDICARE METRAHE
0695883000OtherKEYSTONE HEALTH PLAN EAST
0753481OtherHIGHMARK BLUE SHIELD PABS
1008191OtherAMERIHEALTH MERCY
116641OtherTHREE RIVERS MEDPLUS
7387639001OtherCIGNA
248730OtherMAMSI
116641OtherTHREE RIVERS MEDPLUS
F42003Medicare UPIN