Olesnicky, Mark Theodore
Olesnicky, Mark Theodore is an sole proprietor health care provider with primary practice located at 135 Columbia Trnpk Ste 203, Florham Park NJ 07932. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Olesnicky, Mark Theodore can be contacted via phone (973) 822-3693.Contact Information
Primary practice address
135 Columbia Trnpk Ste 203
Florham Park NJ 07932
Phone: (973) 822-3693
Fax: (973) 822-3321
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 27783 | New Jersey |
Profile Details
| NPI number | 1770503617 |
|---|---|
| LBN Legal business name | Olesnicky, Mark Theodore |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 21st, 2006 |
| Last updated | May 26th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770503617 | NPPES |
| New Jersey | MEDICAID | 1642707 | |
| New Jersey | Other | 222044453 | |
| New Jersey | Other | D08492 | |
| New Jersey | Other | 46931 |
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