MR. MARK PATRICK STEPHAN PA NPI 1699886614

NPI Information

NPI: 1699886614
Provider Name: MR. MARK PATRICK STEPHAN, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
55 SPINDRIFT DR
WILLIAMSVILLE, NY
ZIP 14221
Phone: (716) 447-6310
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MR. Mark Patrick Stephan, PA is a surgical physician assistant in Williamsville, NY. MR. Mark Patrick Stephan, PA NPI is 1699886614. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

55 SPINDRIFT DR
WILLIAMSVILLE, NY
ZIP 14221-800
Phone: (716) 447-6310
Fax: (716) 775-6288

The NPI 1699886614 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 7/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	10867		No
2	363AS0400X	Physician Assistant	Surgical	010867	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	03076359	MEDICAID	NEW YORK
2	Q61885	MEDICARE UPIN	NEW YORK
3	PA1245	MEDICARE PIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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