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General NPI Number Information
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NPI Number | 1669538609
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Entity Type | Individual
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Provider Name | ALLAN I MARCUS OD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 50 MALL DR W
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City | JERSEY CITY
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State | NJ
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Zip | 07310-1601
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Country | US
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Telephone | 201-222-2423
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Fax | 201-420-1750
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Provider Business Mailing Address
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Address Line | 353 BLANKETFLOWER LN
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City | PRINCETON JUNCTION
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State | NJ
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Zip | 08550-2437
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Country | US
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Telephone | 609-371-0805
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00352100
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License Number State | NJ
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