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Individual

DR. MARK JONATHAN MANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
225 MILLBURN AVE STE 304, MILLBURN, NJ 07041-1712
(973) 218-9400
(973) 218-9420
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA09795800
NJ
208800000X
Urology Physician
MD451932
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0421481
NJ
05
102951397 0001
PA
Enumeration date
07/10/2008
Last updated
08/25/2022
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