Individual
MARK WACIEGA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 W MAIN ST, CENTRASTATE MEDICAL CENTER, FREEHOLD, NJ 07728-2537
(732) 294-2666
(732) 431-8267
Mailing address
PO BOX 2680, CENTRAL JERSEY EMERGENCY MEDICINE ASSOCIATES PC, NEW BRUNSWICK, NJ 08903-2680
(800) 666-2455
(610) 617-6280
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA04817600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5477701
—
NJ
Enumeration date
05/24/2006
Last updated
07/08/2007
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