| Doctor Name: | MARK ENZERRA |
| NPI Number: | 1073823365 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A.C. |
| License Number: | MA053764 |
| Business Practice Address: | 100 Witmer Rd Suite 220 Horsham, PA - 190442251 |
| Business Phone Number: | 2154425000 |
| Business Fax Number: | 2159572875 |
| Mailing Address: | 155 Wilson Ave, WASHINGTON |
| State: | PA |
| Postal Code: | 153013336 |
| Phone Number: | 7242233085 |
| Fax Number: | 2159572875 |
| NPI Enumeration Date: | 10/20/2010 |
| NPI Last Update Date: | 10/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146N00000X |
| License Number: | MA053764 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Basic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |