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Individual

MARK ALLEN FORGANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.P

Contact information

Practice address
3317 SUNSET AVE, OCEAN, NJ 07712-4554
(732) 775-3600
Mailing address
3317 SUNSET AVE, OCEAN, NJ 07712-4554
(732) 775-3600

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RS00371900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4367502
NJ
Enumeration date
08/24/2006
Last updated
07/09/2007
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