Mirochnick, Mark H
Mirochnick, Mark H is an individual health care provider with primary practice located at 840 Harrison Ave Menino 3, Boston MA 02118-2905. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Mirochnick, Mark H can be contacted via phone (617) 414-5471.Contact Information
Primary practice address
840 Harrison Ave Menino 3
Boston MA 02118-2905
Phone: (617) 414-5471
Fax: (617) 414-4358
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 51072 | Massachusetts |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 51072 | Massachusetts |
Profile Details
| NPI number | 1508849969 |
|---|---|
| LBN Legal business name | Mirochnick, Mark H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 21st, 2005 |
| Last updated | Jul 17th, 2014 - about 12 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 | 1508849969 | NPPES |
| Massachusetts | MEDICAID | 110042959A |
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