Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 38MC00552600 | NJ |
N | 111NS0005X | Chiropractic Sports Physician | 38MC00552600 | NJ |
NPI | 1295823060 |
---|---|
Provider Name | Dr. Mark Jason Sirninger |
First Address | Whitehouse Station, NJ 08889-3726 |
Second Address | Whitehouse Station, NJ 08889-3726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U93201 | (02) | NJ |