MARK MEDICAL CARE, PLLC (NPI# 1962745398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962745398 |
| Entity Type | Organization |
| Organization Name | MARK MEDICAL CARE, PLLC |
| Practice Address |
2103 Deer Park Ave Ste 200 Deer Park NY 11729-1317 |
| Mailing Address |
6 Annette Way Jericho NY 11753-2836 |
| Practice Telephone | 6315742060 |
| Mailing Telephone | 5163765562 |
| Mailing Fax Number | 9498638548 |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2020-10-19 |
| Authorized Official Name | RON MARK (PRESIDENT) |
| Authorized Official Telephone | 5763765562 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 2147731 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 04427969 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 385 W Sunrise Hwy, Freeport, NY 115203120 | 5163214747 | 8776738535 |
| 5503 Myrtle Ave, Ridgewood, NY 113853550 | 6315742060 | |
| 6405 Woodside Ave, Woodside, NY 113773654 | 8773762751 | 8776738535 |
| Street Address |
2103 DEER PARK AVE STE 200 |
| City | DEER PARK |
| State | NY |
| Zip Code | 11729-1317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326588062 | Diana M. Murillo | Physician Assistant | 2103 Deer Park Ave Ste 200, Deer Park, NY 11729-1317 | 2017-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013561513 | Elyse Joy Wright | Specialist | 1014 Grand Boulevard Suite 5, Deer Park, NY 11729 | 2019-08-01 |
| 1568929131 | Corrine E. Hibbert | Case Manager/Care Coordinator | 140 Villa Avenue, Deer Park Ny, NY 11729 | 2019-03-01 |
| 1922525286 | Melissa Ramistella | Behavioral Analyst | 6 Angelica Street, Deer Park, NY 11729 | 2017-08-28 |
| 1609224153 | Corvitals, Inc. | Clinical Medical Laboratory | 590 Nichols Road, Suite 1, Deer Park, NY 11729 | 2016-05-25 |
| 1417375312 | Venel Maitre | Registered Nurse | 54 Duke St, Deer Park, NY 11729 | 2014-03-29 |
| 1578819157 | Koa K Robinson | Registered Nurse | 375 Carlls Place, 329, Deer Park, NY 11729 | 2012-08-01 |
| 1649532409 | Theresa L Lerro | Counselor | 1 Brandyine Drive, Deer Park, NY 11729 | 2012-06-07 |
| 1417218827 | Abilities Unlimited of N.y. | Durable Medical Equipment & Medical Supplies | 90 E. Jefryn Blvd., Deer Park, NY 11729 | 2012-06-01 |
| 1356600811 | Jennifer A. D'auria | Speech-Language Pathologist | 101 Lake Ave., Jfk Intermediate School, Deer Park, NY 11729 | 2012-05-03 |
| 1013280254 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 1900 The Arches Circle, Deer Park, NY 11729 | 2012-02-20 |
| Find all providers in zip 11729 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013561513 | Elyse Joy Wright | Specialist | 1014 Grand Boulevard Suite 5, Deer Park, NY 11729 | 2019-08-01 |
| 1588160816 | Nicole Jablonski | Specialist | 283 W 18th St, Deer Park, NY 11729-6315 | 2018-04-04 |
| 1376073825 | Winthrop Community Medical Affiliates PC | Specialist | 1920 Deer Park Ave Ste 104, Deer Park, NY 11729-3314 | 2017-06-18 |
| 1134503923 | Vt's Abc Inc. | Specialist | 58 Westwood Ave, Deer Park, NY 11729-2211 | 2015-07-12 |
| 1356732770 | Ximena Osorio | Specialist | 289 W 18th St, Deer Park, NY 11729-6315 | 2015-02-06 |
| 1194147025 | Shari Lynn Lando | Specialist | 29 Nantucket Ln, Deer Park, NY 11729-1012 | 2014-01-12 |
| 1114351657 | Debra Zucchero | Specialist | 305 Old Country Rd, Deer Park, NY 11729-2024 | 2013-08-31 |
| 1003258633 | Lorna A. Vopat | Specialist | 10 W 21st St, Deer Park, NY 11729-3918 | 2013-07-24 |
| 1053655597 | Elizabeth Ann Cort-ranghel | Specialist | 233 Oakland Ave, Annex, Deer Park, NY 11729-5941 | 2012-11-21 |
| 1568713196 | Maria C Hassel | Specialist | 145 Eastwood Ave, Deer Park, NY 11729-2803 | 2012-09-22 |
| Find all providers in DEER PARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.