Henry, Mark William

Henry, Mark William is an individual health care provider with primary practice located at 205 S Orange Ave C-Level #1200, Newark NJ 07103-2785. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Henry, Mark William can be contacted via phone (973) 972-8240.

Contact Information

Primary practice address
205 S Orange Ave C-Level #1200 Newark NJ 07103-2785
Phone: (973) 972-8240
Fax: (973) 972-9367
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 015279 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1098952
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 25MP00331900 New Jersey

Profile Details

NPI number 1578502779
LBN Legal business name Henry, Mark William
Credentials MS, RPA-C, ATC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Mar 9th, 2016 - about 10 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 1578502779 NPPES
Other 1098952 NCCPA
Other 015279 NCCPA

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