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General NPI Number Information
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NPI Number | 1265255574
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Entity Type | Individual
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Provider Name | ALEXANDRA MASON MARKS
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 501 IRON BRIDGE RD STE 10
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City | FREEHOLD
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State | NJ
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Zip | 07728-5305
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Country | US
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Telephone | 918-399-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 383 SAINT ANDREWS PL
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City | MANALAPAN
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State | NJ
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Zip | 07726-9532
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Country | US
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Telephone | 918-399-3838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 26NJ15170600
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License Number State | NJ
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