Individual
DR. MARK VAN KOOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1751 AUTUMN DR, FRANKLINVILLE, NJ 08322-2423
(856) 562-8678
Mailing address
1751 AUTUMN DR, FRANKLINVILLE, NJ 08322-2423
(856) 562-8678
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA03950700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1179504
—
NJ
Enumeration date
10/12/2005
Last updated
09/23/2020
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