Mark Wasserman, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

132521 Issued in NY

Legal business name

MARK WASSERMAN, MD

Practice address

555 Route 25a
Miller Place, NY 11764-2625

Phone

(631) 744-6666

Fax

(631) 744-0525

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Mark Wasserman, MD

Title

MD

Phone

(631) 744-6666

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1396824306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 ROUTE 25A",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642625",
            "telephone_number": "631-744-6666",
            "fax_number": "631-744-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 ROUTE 25A",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642625",
            "telephone_number": "631-744-6666",
            "fax_number": "631-744-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK WASSERMAN, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "WASSERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "631-744-6666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "132521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joelle T. Manzo, LCSW
• Stacey Lee Marando, LMSW
• Marc Avvento DC PC
• Victoria Margulies
• Kimberly Ann Marino, MA, CCC, SLP
• Marian Margaretta Marshall, O.T.R./L.
• Elizabeth Martin
• Maryhaven Center of Hope Inc.
• Maryhaven Center of Hope Inc.
• Casey Masalehdani, M.A., CCC-SLP, TSSLD

• Family Medicine Physician in Miller Place, NY
• Providers in Miller Place, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.