Baesl, Mark T.

Baesl, Mark T. is an sole proprietor health care provider with primary practice located at 301 Prospect Ave Dept. Of Radiology, Syracuse NY 13203-1807. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Baesl, Mark T. can be contacted via phone (315) 703-2138.

Contact Information

Primary practice address
301 Prospect Ave Dept. Of Radiology Syracuse NY 13203-1807
Phone: (315) 703-2138
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD438193 Pennsylvania
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD438193 Pennsylvania
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 25MA08811900 New Jersey
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 260730 New York
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 260730 New York

Profile Details

NPI number 1750547386
LBN Legal business name Baesl, Mark T.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2008
Last updated Feb 5th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750547386 NPPES
Pennsylvania MEDICAID 102469026-0001
Pennsylvania MEDICAID 0233510

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