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Individual

DR. MARK JACK DER MESROPIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 222-5200
Mailing address
300 OCEAN AVE N, APT 2B, LONG BRANCH, NJ 07740-7578
(315) 447-0857

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
051857
CT
207L00000X
Anesthesiology Physician
Primary
25MB10061600
NJ

Other

Enumeration date
09/01/2011
Last updated
01/23/2023
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