Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | MA059701 | NJ |
NPI | 1225283310 |
---|---|
Provider Name | Dr. Mark Allen Bach |
First Address | Scotch Plains, NJ 07076-4702 |
Second Address | Scotch Plains, NJ 07076-4702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2008 |
Last Update Date | 14/11/2009 |