Basic Information
| Provider Information | |||||||||
| NPI: | 1457388050 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REKANT | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 950 PULASKI DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | KING OF PRUSSIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194062802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107685940 | ||||||||
| FaxNumber: | 6107685947 | ||||||||
| Practice Location | |||||||||
| Address1: | 1888 MARLTON PIKE E | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080032178 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107685940 | ||||||||
| FaxNumber: | 6107685947 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2006 | ||||||||
| LastUpdateDate: | 06/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0106X | MA69574 | NJ | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 2085R0202X | MA69574 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | MD069522L | PA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2086S0105X | MA69574 | NJ | N | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand | 2086S0105X | MD069522L | PA | N | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand | 2251H1200X | MA69574 | NJ | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Hand | 2251H1200X | MD069522L | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Hand | 225XH1200X | MA69574 | NJ | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand | 225XH1200X | MD069522L | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand | 207XS0106X | MD069522L | PA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0867456000 | 01 | PA | INDEPENDENCE BLUE CROSS | OTHER | 923282 | 01 | PA | PENNSYLVANIA BLUE SHIELD | OTHER | 200042331 | 01 | PA | RAILROAD MEDICARE | OTHER |