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General NPI Number Information
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NPI Number | 1477718237
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Entity Type | Organization
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Legal Business Name | MARC S MENKOWITZ MD LLC
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 1131 BROAD ST SUITE 201
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4329
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Country | US
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Telephone | 732-380-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 1131 BROAD ST SUITE 201
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4329
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Country | US
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Telephone | 732-380-1212
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARC S MENKOWITZ
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Credential | MD
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Telephone | 732-380-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 25MA07684500
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License Number State | NJ
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