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NPI Code Detail

MEDICARE: MARK STAROSELSKY DO

MEDICARE: MARK STAROSELSKY DO
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
1207R00000XInternal Medicine Physician25MB11149900NJ
2207RC0000XCardiovascular Disease Physician25MB11149900NJ
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1659864197
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK STAROSELSKY DO
Provider Business Mailing Address
First Line : 200 TRENTON RD
Second Line :
City : BROWNS MILLS
State : NJ
Zip : 08015-1764
Country : US
Telephone Number : 609-893-6611
Fax Number :
Provider Business Practice Location Address
First Line : 200 TRENTON RD
Second Line :
City : BROWNS MILLS
State : NJ
Zip : 08015-1764
Country : US
Telephone Number : 609-893-6611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2018
Last Update Date : 02/26/2026

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