MEDICARE: MARK ADLER MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW015214	PA
2	1041C0700X	Clinical Social Worker	44SC05304500	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2321560000	OTHER	PA	IBC
2	349814000	OTHER	PA	KEYSTONE
3	7492508	OTHER	PA	AETNA

General Provider Information

NPI Number	:	1457462723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ADLER MSW

Provider Business Mailing Address
First Line	:	12 HALO AVE
Second Line	:
City	:	SEWELL
State	:	NJ
Zip	:	08080-2112
Country	:	US
Telephone Number	:	856-701-5022
Fax Number	:

Provider Business Practice Location Address
First Line	:	8400 BUSTLETON AVE
Second Line	:	SUITE 200
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-1918
Country	:	US
Telephone Number	:	610-644-6464
Fax Number	:	610-644-4066

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/23/2024

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Directions to “ MARK ADLER MSW” Practice Location

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