Individual
DR. MARC T ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD ANESTHESIOLOGIST
Contact information
Practice address
509 N BROAD ST, WOODBURY, NJ 08096-1617
(856) 845-0100
(856) 848-7023
Mailing address
509 N BROAD ST, WOODBURY, NJ 08096-1617
(856) 845-0100
(856) 848-7023
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0026662
—
NJ
01
—
25MA07616000
MEDICAL LICENSE
NJ
01
—
D08410700
CDS
NJ
Enumeration date
09/12/2005
Last updated
03/07/2023
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