Mark, Martin O

Mark, Martin O is an individual health care provider with primary practice located at 1966 3Rd Ave , New York NY 10029-3602. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mark, Martin O can be contacted via phone (212) 534-1020.

Contact Information

Primary practice address
1966 3Rd Ave New York NY 10029-3602
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TUV002752 New York

Profile Details

NPI number 1609874221
LBN Legal business name Mark, Martin O
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Nov 19th, 2008 - about 18 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 1609874221 NPPES
New York MEDICAID 00329979

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