Provider Demographics
NPI:1801978366
Name:HECHT, MARK DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:DAVID
Last Name:HECHT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:550 SUMMIT AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2707
Mailing Address - Country:US
Mailing Address - Phone:201-659-4322
Mailing Address - Fax:201-659-5758
Practice Address - Street 1:550 SUMMIT AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2707
Practice Address - Country:US
Practice Address - Phone:201-659-4322
Practice Address - Fax:201-659-5758
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ3648152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0372200-01Medicaid
NJUZ6861Medicare UPIN
NJ0372200-01Medicaid