Richard N Mark, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

002725-1 Issued in NY

Practice address

3 Technology Dr Ste 400
East Setauket, NY 11733-4078

Phone

(631) 751-8000

Fax

(631) 751-8030

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Charles Hospital Corp

  dba St. Charles Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1164481529
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255453965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 WYANDANCH BLVD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117874293",
            "telephone_number": "631-864-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 TECHNOLOGY DR STE 400",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334078",
            "telephone_number": "631-751-8000",
            "fax_number": "631-751-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "RICHARD",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "002725-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamed Mohsen Mansour, M.D.
• Marc Greenstein Acupuncture, PLLC.
• Jenna Kelly Marcel, FNP-BC
• Josephine Marcel, LAC
• Mark Goldberg Prosthetic & Orthotic Labs, Inc.
• Stephanie Marie Marotta
• Carol Ann Martin, NP
• Jeanne Martin, N.P.
• Jillian Martin
• Angelo Marullo

• Physical Therapy Assistant in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Physical Therapy Assistant in New York

• 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.

Verify at the official NPI Registry.