Theodore, Mark

Theodore, Mark is an sole proprietor health care provider with primary practice located at 1656 Champlin Ave , Utica NY 13502-4830. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Theodore, Mark can be contacted via phone (315) 624-6000.

Contact Information

Primary practice address
1656 Champlin Ave Utica NY 13502-4830
Phone: (315) 624-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Critical Care Medicine 163WC0200X 629932 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 338083 New York

Profile Details

NPI number 1457793135
LBN Legal business name Theodore, Mark
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 23rd, 2013
Last updated Jul 23rd, 2013 - about 13 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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