Provider Demographics
NPI:1053706010
Name:MARDER, BENJAMIN LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:LEE
Last Name:MARDER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 S DELSEA DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5308
Mailing Address - Country:US
Mailing Address - Phone:856-690-1616
Mailing Address - Fax:856-896-6107
Practice Address - Street 1:352 S DELSEA DR UNIT C
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5308
Practice Address - Country:US
Practice Address - Phone:856-690-1616
Practice Address - Fax:856-896-6107
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006669213ES0103X
390200000X
NJ25MD00354300213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty