| Mark White, Ph.d., P.a. | |
|
2517 Highway 35 Building J, Suite 101 Manasquan NJ 08736-1918 | |
| (732) 528-7844 | |
| (732) 528-0040 |
| Full Name | Mark White, Ph.d., P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 2517 Highway 35, Manasquan, New Jersey |
| Authorized Official Name and Position | Mark White (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7325287844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark White, Ph.d., P.a. 2517 Highway 35 Building J, Suite 101 Manasquan NJ 08736-1918 Ph: (732) 528-7844 | Mark White, Ph.d., P.a. 2517 Highway 35 Building J, Suite 101 Manasquan NJ 08736-1918 Ph: (732) 528-7844 |
| NPI Number | 1194027045 |
|---|---|
| Provider Enumeration Date | 11/29/2010 |
| Last Update Date | 12/16/2010 |
| Medicare PECOS PAC ID | 5193913036 |
|---|---|
| Medicare Enrollment ID | O20101220000807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194027045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 35SI00156500 (New Jersey) | Primary |
| Provider Name | Mark A White |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205956711 PECOS PAC ID: 0345438206 Enrollment ID: I20101220001003 |
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