Provider Demographics
NPI:1982600367
Name:MAKAR, MARY (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:MAKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 CHAPEL AVE W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1592
Mailing Address - Country:US
Mailing Address - Phone:856-667-3937
Mailing Address - Fax:856-667-0661
Practice Address - Street 1:3001 CHAPEL AVE W
Practice Address - Street 2:SUITE 200
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-1592
Practice Address - Country:US
Practice Address - Phone:856-667-3937
Practice Address - Fax:856-667-0661
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0425464207W00000X
NJ25MA07481400207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0033898Medicaid
NJ0033898Medicaid
NJ080829Medicare ID - Type UnspecifiedINDIV NJ MEDICARE NUMBER
PAI15125Medicare UPIN