Provider Demographics
NPI:1932164845
Name:MAJESKI, MARK A (DPM)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:MAJESKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7456
Mailing Address - Country:US
Mailing Address - Phone:732-349-0114
Mailing Address - Fax:732-349-0228
Practice Address - Street 1:618 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7456
Practice Address - Country:US
Practice Address - Phone:732-349-0114
Practice Address - Fax:732-349-0228
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001939213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1396307Medicaid
NJ606097Medicare ID - Type Unspecified
NJT93271Medicare UPIN