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Individual

MARK PERNICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2106 NEW RD, SUITE D1, LINWOOD, NJ 08221-1050
(609) 927-9545
(609) 927-2920
Mailing address
2106 NEW RD, SUITE D1, LINWOOD, NJ 08221-1050
(609) 927-9545
(609) 927-2920

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB04100800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0010640
US HEALTHCARE
NJ
01
0100759001
AMERIHEALTH
NJ
01
156502908
UNITED HEALTHCARE
NJ
05
2013207
NJ
01
F09371
HEALTHNET
NJ
01
NJ41008
MUTUAL OF OMAHA
NJ
Enumeration date
05/19/2006
Last updated
07/19/2011
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