Provider Demographics
NPI:1871609149
Name:STARKMAN, MOISHE (MD)
Entity type:Individual
Prefix:
First Name:MOISHE
Middle Name:
Last Name:STARKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 US HIGHWAY 130 STE 1B
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-2249
Mailing Address - Country:US
Mailing Address - Phone:609-298-2992
Mailing Address - Fax:609-291-8359
Practice Address - Street 1:4000 ROUTE 130 BLDG C
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-2414
Practice Address - Country:US
Practice Address - Phone:856-705-0685
Practice Address - Fax:856-705-0686
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA50962173000000X
NJ25MA05096200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE22083Medicare UPIN
NJ036612ZPCNMedicare PIN