Individual
DR. MARK I SISSKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 SUNSET AVE, SUITE 100, OCEAN, NJ 07712-4556
(732) 774-4114
(732) 774-6869
Mailing address
3200 SUNSET AVE, SUITE 100, OCEAN, NJ 07712-4556
(732) 774-4114
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA04343400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0K7979
HEALTHNET
NJ
01
—
110172478
RAILROAD MEDICARE
NJ
05
—
1785702
—
NJ
01
—
223360408-019
QUALCARE
NJ
01
—
P403608
OXFORD
NJ
Enumeration date
02/13/2006
Last updated
10/01/2008
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