Provider Demographics
NPI:1952745317
Name:MARC I STORCH MD PC
Entity Type:Organization
Organization Name:MARC I STORCH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:IRA
Authorized Official - Last Name:STORCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-284-9221
Mailing Address - Street 1:1100 WESCOTT DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4600
Mailing Address - Country:US
Mailing Address - Phone:908-284-9221
Mailing Address - Fax:908-237-2366
Practice Address - Street 1:1100 WESCOTT DR
Practice Address - Street 2:SUITE 106
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4600
Practice Address - Country:US
Practice Address - Phone:908-284-9221
Practice Address - Fax:908-237-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-28
Last Update Date:2013-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ59225261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty