Weidner, Mark H

Weidner, Mark H is an individual health care provider with primary practice located at 2 Broad Street Plz Broad Street Medical Group, Glens Falls NY 12801-4363. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Weidner, Mark H can be contacted via phone (518) 926-1770.

Contact Information

Primary practice address
2 Broad Street Plz Broad Street Medical Group Glens Falls NY 12801-4363
Phone: (518) 926-1770
Fax: (518) 926-1799
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 210870 New York

Profile Details

NPI number 1972680288
LBN Legal business name Weidner, Mark H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jun 8th, 2009 - about 17 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 1972680288 NPPES
New York MEDICAID 01609810
New York Other RB8388
New York MEDICAID 0VN1263

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