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Contact Information

MARK A DECOTIIS, DPM
721 N BEERS ST
STE. 2C
HOLMDEL, NJ07733-1518
 Phone: 732-888-1717
 Fax: 732-888-2101
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MARK A DECOTIIS · (Male)

NPI Number 1851360036
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 03/17/2006
Last updated 03/17/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # MD02381
  • Other 10654598 CAQH
  • Other PJ3001 EMPIRE BCBS
  • Other 2K6416 HEALTH NET
  • Other P1093167 OXFORD ID
Hospital affiliation(s)
  • BAYSHORE COMMUNITY HOSPITAL - (Acute Care)
    727 N BEERS ST
    HOLMDEL, NJ 07733
  • JERSEY SHORE UNIVERSITY MEDICAL CENTER - (Acute Care)
    1945 RTE 33
    NEPTUNE, NJ 07754
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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