Benjamin Mark, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA42033 Issued in NJ

Practice address

279 3Rd Ave
Suite 301
Long Branch, NJ 07740-6205

Phone

(732) 229-3737

Fax

(732) 229-5757

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093704199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 3RD AVE",
            "address_2": "SUITE 301",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406205",
            "telephone_number": "732-229-3737",
            "fax_number": "732-229-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 3RD AVE",
            "address_2": "SUITE 301",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406205",
            "telephone_number": "732-229-3737",
            "fax_number": "732-229-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA42033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Franca M. Mancini, PH.D., LPC
• Pranathi Reddy Mandadi, M.D.
• Annapurna Lakshmi Sravanti Mandalika, MD
• Leo Marcus
• Erica Margolias, DMD
• Brittany Martin, P.A.
• Lorrainne M Martinez, RN
• Nathalie Mari Martinez, MD
• Chelsea Helen Masler, CNM
• Katie Ann Mason

• Specialist in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.