Provider Demographics
NPI:1295808236
Name:MARS, AUDREY ESTELLE (MD)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:ESTELLE
Last Name:MARS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 ROUTE 31 STE 500
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5763
Mailing Address - Country:US
Mailing Address - Phone:908-788-6500
Mailing Address - Fax:908-788-2578
Practice Address - Street 1:190 ROUTE 31 STE 500
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5763
Practice Address - Country:US
Practice Address - Phone:908-788-6500
Practice Address - Fax:908-788-2578
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA049149L208000000X
NJ25MA63775002080P0006X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics