Grudman, Mark
Grudman, Mark is an individual health care provider with primary practice located at 393 Sunrise Highway , West Babylon NY 11704-5909. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Grudman, Mark can be contacted via phone (631) 228-5540.Contact Information
Primary practice address
393 Sunrise Highway
West Babylon NY 11704-5909
Phone: (631) 228-5540
Fax: (631) 396-6861
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 192167 | New York |
Profile Details
| NPI number | 1750330049 |
|---|---|
| LBN Legal business name | Grudman, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2006 |
| Last updated | May 20th, 2023 - about last year |
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 | 1750330049 | NPPES |
| New York | MEDICAID | 01762716 |
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