Individual
DR. MARK ERIC SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 PROSPECT AVE, IMUS BLDG, 3RD FL, HACKENSACK UNIV. MEDICAL CENTER, HACKENSACK, NJ 07601-1914
(201) 996-2403
Mailing address
30 PROSPECT AVE, IMUS BLDG, 3RD FL, HACKENSACK UNIV. MEDICAL CENTER, HACKENSACK, NJ 07601-1914
(201) 996-2403
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
201727
NY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MA072770
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105635
—
NJ
Enumeration date
10/23/2006
Last updated
07/09/2007
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