Individual
DR. MARK STEVEN WAXMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
312 BELLEVILLE TPKE, SUITE 1B, NORTH ARLINGTON, NJ 07031-6463
(201) 997-6776
(201) 997-6610
Mailing address
15 MCDONOUGH PL, WEST CALDWELL, NJ 07006-4226
(973) 228-9171
(201) 997-6610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03630700
NJ
207RG0100X
Gastroenterology Physician
25MA03630700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60133446
—
NJ
Enumeration date
02/14/2006
Last updated
06/16/2018
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