Smith, Mark

Smith, Mark is an sole proprietor health care provider with primary practice located at 4802 10Th Ave , Brooklyn NY 11219-2916. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Smith, Mark can be contacted via phone (718) 283-8773.

Contact Information

Primary practice address
4802 10Th Ave Brooklyn NY 11219-2916
Fax: (718) 283-8796
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 145831 New York

Profile Details

NPI number 1093885485
LBN Legal business name Smith, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 9th, 2006
Last updated Mar 11th, 2009 - about 15 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 1093885485 NPPES
New York MEDICAID 00755197

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