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General NPI Number Information
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NPI Number | 1336149319
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Entity Type | Individual
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Provider Name | MARK THOMAS DIMARCANGELO D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 1 COOPER PLZ
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City | CAMDEN
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State | NJ
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Zip | 08103-1461
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Country | US
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Telephone | 856-342-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FEDERAL ST # 200
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City | CAMDEN
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State | NJ
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Zip | 08103-1088
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Country | US
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Telephone | 856-356-4924
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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 | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 25MB04275400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 25MB04275400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OS005133L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C20007195
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 25MB04275400
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MB04275400
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License Number State | NJ
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