Gudesblatt, Mark
Gudesblatt, Mark is an individual health care provider with primary practice located at 712 Main St , Islip NY 11751-3620. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Gudesblatt, Mark can be contacted via phone (631) 666-3939.Contact Information
Primary practice address
712 Main St
Islip NY 11751-3620
Phone: (631) 666-3939
Fax: (631) 666-3994
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 147227 | New York |
Profile Details
| NPI number | 1528030269 |
|---|---|
| LBN Legal business name | Gudesblatt, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Sep 13th, 2016 - about 8 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 | 1528030269 | NPPES |
| New York | MEDICAID | 01158790 |
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