Provider Demographics
NPI:1992107858
Name:BATZOFIN, BARUCH MARK
Entity type:Individual
Prefix:DR
First Name:BARUCH
Middle Name:MARK
Last Name:BATZOFIN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:BRETT
Other - Middle Name:MARK
Other - Last Name:BATZOFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBCH (MD)
Mailing Address - Street 1:7035 WALLIS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1710
Mailing Address - Country:US
Mailing Address - Phone:410-413-0806
Mailing Address - Fax:
Practice Address - Street 1:7035 WALLIS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1710
Practice Address - Country:US
Practice Address - Phone:410-413-0806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program