Individual
MARK JOSEPH OBERTHALER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
504 VALLEY RD, WAYNE, NJ 07470-3534
(973) 694-2690
Mailing address
504 VALLEY RD, WAYNE, NJ 07470-3534
(973) 694-2690
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
ER25MP00337700
NJ
Other
Enumeration date
07/27/2014
Last updated
07/28/2014
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