| Organization Name: | MARK MADIS,M.D. , LLC |
| NPI Number: | 1124235452 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK STEVEN MADIS (OWNER) |
| Mailing Address: | 212 Route 94 Suite 1a Vernon |
| State: | NJ US |
| Postal Code: | 074623328 |
| Phone Number: | 9738645033 |
| Fax Number: | |
| NPI Enumeration Date: | 05/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 25MA04014100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |