Individual
MARK ANTHONY DECOTIIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
721 N BEERS ST, STE. 2C, HOLMDEL, NJ 07733-1518
(732) 888-1717
(732) 888-2101
Mailing address
721 N BEERS ST, STE. 2C, HOLMDEL, NJ 07733-1518
(732) 888-1717
(732) 888-2101
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
MD02381
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10654598
CAQH
—
01
—
2K6416
HEALTH NET
—
01
—
P1093167
OXFORD ID
—
01
—
PJ3001
EMPIRE BCBS
—
Enumeration date
03/17/2006
Last updated
03/17/2014
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