Preston, Mark
Preston, Mark is an individual health care provider with primary practice located at 60 Westwood Ave Ste 200, Waterbury CT 06708. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is his primary health care specialty. Preston, Mark can be contacted via phone (203) 574-5501.Contact Information
Primary practice address
60 Westwood Ave Ste 200
Waterbury CT 06708
Phone: (203) 574-5501
Fax: (203) 596-0912
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 040237 | Connecticut |
| Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery | 207VF0040X | 040237 | Connecticut |
Profile Details
| NPI number | 1902992274 |
|---|---|
| LBN Legal business name | Preston, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2006 |
| Last updated | Nov 26th, 2013 - 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 | 1902992274 | NPPES |
| Connecticut | MEDICAID | 001402370 |
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