John J Mark Jr., DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

147046 Issued in NY

Practice address

990 Stewart Ave
Garden City, NY 11530-4822

Phone

(516) 222-2022

Fax

(516) 222-8475

NPI assigned

Nov 4, 2006

Last updated

Apr 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1710066188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304822",
            "telephone_number": "516-222-2022",
            "fax_number": "516-222-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304822",
            "telephone_number": "516-222-2022",
            "fax_number": "516-222-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARK",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-04",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "147046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00721444",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Mulligan Psychologist PLLC
• Lorraine Alice Marin, M.D.
• Richard Thomas Marino III, PA-C
• Mark Fleckner M.D., P.C.
• Mark N. Goldstein M.D., P.C.
• Judith L Mark, DO
• Speranza D Marmo, REGISTERED NURSE
• Valerie Christine Marquis Auerbach, MS CCC-SLP
• Anthony John Marra, ATC
• David B. Marshall, M.D.

• Family Medicine Physician in Garden City, NY
• Providers in Garden City, 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 Apr 21, 2011; 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.