Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00354300 | NJ |
N | 213ES0103X | Foot & Ankle Surgery | SC006669 | PA |
NPI | 1053706010 |
---|---|
Provider Name | Dr. Benjamin Lee Marder |
First Address | Vineland, NJ 08360-4800 |
Second Address | Vineland, NJ 08360-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 27/08/2020 |