| Doctor Name: | MARK A CANNING |
| NPI Number: | 1366548141 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSN |
| License Number: | 26NN10236800 |
| Business Practice Address: | 3 Farrington St Vauxhall, NJ - 070881307 |
| Business Phone Number: | 9739717185 |
| Business Fax Number: | |
| Mailing Address: | Po Box 23831, NEWARK |
| State: | NJ |
| Postal Code: | 071890001 |
| Phone Number: | 9739717185 |
| Fax Number: | |
| NPI Enumeration Date: | 09/16/2006 |
| NPI Last Update Date: | 07/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 26NN10236800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |