Izzo, Mark R

Izzo, Mark R is an individual health care provider with primary practice located at 2315 Myrtle St Ste 190 , Erie PA 16502-4604. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Izzo, Mark R can be contacted via phone (814) 453-7767.

Contact Information

Primary practice address
2315 Myrtle St Ste 190 Erie PA 16502-4604
Fax: (814) 454-6667
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD045842L Pennsylvania
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X MD045842L Pennsylvania

Profile Details

NPI number 1811975584
LBN Legal business name Izzo, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Sep 30th, 2020 - about 4 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 1811975584 NPPES
Pennsylvania Other 060064728 RR MEDICARE
Pennsylvania MEDICAID 0071050780002 RR MEDICARE

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