Delaurentis, Mark

Delaurentis, Mark is an individual health care provider with primary practice located at 100 Carnie Blvd Suite B-5, Voorhees NJ 08043-4512. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Delaurentis, Mark can be contacted via phone (856) 751-0123.

Contact Information

Primary practice address
100 Carnie Blvd Suite B-5 Voorhees NJ 08043-4512
Phone: (856) 751-0123
Fax: (856) 751-0535
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 25MA04847600 New Jersey
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 25MA04847600 New Jersey

Profile Details

NPI number 1134127178
LBN Legal business name Delaurentis, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Dec 14th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134127178 NPPES
Other 3097883 AETNA
Other 509023 AETNA
Other 1168017 AETNA
Other 509023 AETNA
Other 0109898000 AETNA
Other 10434061 AETNA
Other 300133897 AETNA
Other A3738029 AETNA
MEDICAID 7940602 AETNA

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