Healthcare Provider Details

I. General information

NPI: 1356319180
Provider Name (Legal Business Name): MARK J ZUCKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 PERRY ST
MORRISTOWN NJ
07960-9446
US

IV. Provider business mailing address

PO BOX 824967
PHILADELPHIA PA
19182-4967
US

V. Phone/Fax

Practice location:
  • Phone: 973-984-2222
  • Fax: 973-984-2122
Mailing address:
  • Phone: 800-941-8933
  • Fax: 732-918-8940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberNJMA45124
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberNJMA45124
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: