Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 174507 | NY |
N | 207N00000X | Dermatologist | 174507-1 | NY |
N | 207NS0135X | Procedural Dermatology | 174507-1 | NY |
NPI | 1023017464 |
---|---|
Provider Name | Dr. Mark R Kahn |
First Address | Lynbrook, NY 11563-2640 |
Second Address | Valley Stream, NY 11581-1011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 27/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01836048 | (05) | NY |
43K691 | (02) | NY |
F27843 | (02) | NY |