MEDICARE: DR. MARK A DEMASI DO

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	207V00000X	Obstetrics & Gynecology Physician	25MB05372900	NJ

General Provider Information

NPI Number	:	1922080340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A DEMASI DO

Provider Business Mailing Address
First Line	:	501 BAY AVE STE 202
Second Line	:
City	:	SOMERS POINT
State	:	NJ
Zip	:	08244-2554
Country	:	US
Telephone Number	:	609-904-2173
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 BAY AVE STE 202
Second Line	:
City	:	SOMERS POINT
State	:	NJ
Zip	:	08244-2554
Country	:	US
Telephone Number	:	609-904-2173
Fax Number	:	609-904-6185

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

Provider Enumeration Date	:	11/20/2005
Last Update Date	:	02/11/2025

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