MEDICARE: MARK J SOFFER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	MD024817E	PA
2	207RI0011X	Interventional Cardiology Physician	25MA04412300	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	060045609	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0300863000	OTHER	PA	KEYSTONE
4	0054974000	OTHER	NJ	AMERIHEALTH
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	423703	OTHER	PA	PENNSYLVANIA BLUE SHIELD
7	033779	OTHER	NJ	PENNSYLVANIA BLUE SHIELD

General Provider Information

NPI Number	:	1497722060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK J SOFFER MD

Provider Business Mailing Address
First Line	:	104 PHEASANT RUN
Second Line	:	SUITE 128
City	:	NEWTOWN
State	:	PA
Zip	:	18940-3439
Country	:	US
Telephone Number	:	215-860-3344
Fax Number	:	215-860-8950

Provider Business Practice Location Address
First Line	:	1 UNION ST
Second Line	:	SUITE 101
City	:	ROBBINSVILLE
State	:	NJ
Zip	:	08691-4183
Country	:	US
Telephone Number	:	609-890-6677
Fax Number	:	609-890-7292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	05/24/2021

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Directions to “ MARK J SOFFER MD” Practice Location

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