Individual provider Active NPI

Mary Mark

  • Contractor
  • Brooklyn, NY
National Provider Identifier
1497267165
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
206949031 Issued in NY
Practice address
175 Remsen St Ste 750
Brooklyn, NY 11201-4382
Phone
(718) 522-7300
NPI assigned
Nov 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 206949031 NY Primary

Addresses

Primary practice location

175 Remsen St Ste 750
Brooklyn, NY 11201-4382

Mailing address

3711 35TH Ave Ste 3C
Astoria, NY 11101-1441
Phone (718) 706-7500

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

State licenses

LicenseStateTypeSpecialty
206949031NYMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1497267165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 35TH AVE STE 3C",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111011441",
            "telephone_number": "718-706-7500",
            "fax_number": "718-706-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 REMSEN ST STE 750",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014382",
            "telephone_number": "718-522-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "206949031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.