Stephan, Mark Patrick

Stephan, Mark Patrick is an individual health care provider with primary practice located at 55 Spindrift Dr , Williamsville NY 14221-7800. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Stephan, Mark Patrick can be contacted via phone (716) 447-6310.

Contact Information

Primary practice address
55 Spindrift Dr Williamsville NY 14221-7800
Phone: (716) 447-6310
Fax: (716) 775-6288
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 010867 New York
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 10867

Profile Details

NPI number 1699886614
LBN Legal business name Stephan, Mark Patrick
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 9th, 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 1699886614 NPPES
New York MEDICAID 03076359

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