Healthcare Provider Details

I. General information

NPI: 1467870436
Provider Name (Legal Business Name): MARK BAUERNFEIND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 OAK HILL RD
RED BANK NJ
07701-5727
US

IV. Provider business mailing address

80 OAK HILL RD
RED BANK NJ
07701-5727
US

V. Phone/Fax

Practice location:
  • Phone: 731-741-2313
  • Fax: 817-416-0108
Mailing address:
  • Phone: 732-741-2313
  • Fax: 732-936-8445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberR5506
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MA12626000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: