33D2059045 CLIA NUMBER - DOCTOR MARK PHYSICIAN, PC

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Laboratory Demographics

CLIA Number: 33D2059045

Facility Name: DOCTOR MARK PHYSICIAN, PC

Facility Address:
100 EINSTEIN LOOP N, BUILDING 28 C, GROUND FLOOR
BRONX, NY
ZIP 10475
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Facility Phone Number: 347 541-6241

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1447554605

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	33D2059045
LAB Type	Physician Office
Facility Name	DOCTOR MARK PHYSICIAN, PC
Street	100 EINSTEIN LOOP N, BUILDING 28 C, GROUND FLOOR
City	BRONX
State	NY
ZIP	10475
Phone	347 541-6241
CertificateType	4
CertificateEffectiveDate	5/17/2023
CertificateExpirationDate	5/16/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024