Coronel, Mark Jacob
Coronel, Mark Jacob is an individual health care provider with primary practice located at 287 Wading River Rd Unit 2, Manorville NY 11949. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Coronel, Mark Jacob can be contacted via phone (631) 591-3000.Contact Information
Primary practice address
287 Wading River Rd Unit 2
Manorville NY 11949
Phone: (631) 591-3000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 247949 | New York |
Profile Details
| NPI number | 1346416963 |
|---|---|
| LBN Legal business name | Coronel, Mark Jacob |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2008 |
| Last updated | Jan 4th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346416963 | NPPES |
| New York | Other | 454858453 | NYS |
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