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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508849969 NPPES
Massachusetts MEDICAID 110042959A

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