Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 0404331 | NY |
Y | 213EG0000X | General Practice | 0404331 | NY |
NPI | 1003807975 |
---|---|
Provider Name | Dr. Mark Jeffrey Drukartz |
First Address | Forest Hills, NY 11375-6322 |
Second Address | Brooklyn, NY 11203-1809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 11/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02514529 | (05) | NY |