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Individual
DR. MARC MITNICK
Active
Individual
DR. MARC MITNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00109000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222236123
TAX ID
NJ
Enumeration date
08/04/2005
Last updated
12/12/2007
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