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
Phone: (814) 453-7767
Fax: (814) 454-6667
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811975584 | NPPES |
| Pennsylvania | Other | 060064728 | RR MEDICARE |
| Pennsylvania | MEDICAID | 0071050780002 | RR MEDICARE |
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