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Contact Information

MARK WALLEN, MD
42 LAUREL RD E
SUITE # 3610
STRATFORD, NJ08084-1354
 Phone: 856-482-9000
 Fax: 856-482-1159
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for MARK WALLEN · (Male)

NPI Number 1366416901
Status Active
Credentials MD
Entity Individual
Enumeration date 02/13/2006
Last updated 11/18/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # MA03512400
  • NJ Medicaid 7596707
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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