Mark, Ron

Mark, Ron is an individual health care provider with primary practice located at 2103 Deer Park Ave , Deer Park NY 11729-1319. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mark, Ron can be contacted via phone (631) 574-2060.

Contact Information

Primary practice address
2103 Deer Park Ave Deer Park NY 11729-1319
Phone: (631) 574-2060
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X TM2010-0634 New Mexico
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 214773 New York

Profile Details

NPI number 1013917301
LBN Legal business name Mark, Ron
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Mar 26th, 2024 - about 9 months 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 1013917301 NPPES
New York MEDICAID 02583631
New York Other P00221729

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