Active NPI
Mark B Wishnuff, MD
- Internal Medicine Physician
- Garden City, NY
National Provider Identifier
1124237318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 167462
- Practice address
- 700 Commercial Ave
Garden City, NY 11530-6410 - Phone
- (516) 542-0100
- Fax
- (516) 228-8057
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 167462 | NY | Primary |
Addresses
Primary practice location
700 Commercial Ave
Garden City, NY 11530-6410
Mailing address
215 E 84TH St
New York, NY 10028-2950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 167462 | NY | MD | Internal Medicine Physician |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CHBABA/Endpoint/CHBABA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124237318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 E 84TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100282950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 COMMERCIAL AVE",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115306410",
"telephone_number": "516-542-0100",
"fax_number": "516-228-8057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISHNUFF",
"first_name": "MARK",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "167462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.