Healthcare Provider Details

I. General information

NPI: 1285538975
Provider Name (Legal Business Name): M.S.D.D LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1684 PLATTE AVE
NORTH BRUNSWICK NJ
08902-1422
US

IV. Provider business mailing address

1684 PLATTE AVE
NORTH BRUNSWICK NJ
08902-1422
US

V. Phone/Fax

Practice location:
  • Phone: 848-207-8239
  • Fax:
Mailing address:
  • Phone: 848-207-8239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MARIE MARSH
Title or Position: CEO
Credential:
Phone: 848-207-8239