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KENNETH MARK MD PC NPI 1992982748


NPI Information

NPI: 1992982748
Provider Name: KENNETH MARK MD PC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

Address:
425 COUNTY ROAD 39A
SUITE 201
SOUTHAMPTON, NY
ZIP 11968
Phone: (631) 283-0002
Get Directions

KENNETH MARK MD PC is a mohs-micrographic surgery dermatology in Southampton, NY. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. KENNETH MARK MD PC NPI is 1992982748. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

425 COUNTY ROAD 39A
SUITE 201
SOUTHAMPTON, NY
ZIP 11968-277
Phone: (631) 283-0002
Fax: (631) 283-1932

The provider's authorized official is Kenneth Andre Mark .
The authorized official title is Physician and has the following contact phone number (631) 283-0002.

The enumeration date for this NPI number is 1/23/2008 and was last updated on 4/3/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatology204164NEW YORKNo
2207NS0135XDermatologyProcedural Dermatology204164NEW YORKNo
3207ND0101XDermatologyMOHS-Micrographic Surgery204164NEW YORKYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WZYPV1MEDICARE PINNEW YORK
22K3301MEDICARE PINNEW YORK
3H34850MEDICARE UPINNEW 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: 4/28/2024

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