Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 288898 | NY |
N | 208600000X | Surgeon | 288898 | NY |
Y | 2086S0129X | Vascular Surgeon | 288898 | NY |
NPI | 1023085107 |
---|---|
Provider Name | Mark K Hirko |
First Address | Lagrangeville, NY 12540-5144 |
Second Address | Poughkeepsie, NY 12601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 26/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0368954 | (05) | NJ |
04773300 | (05) | NY |
G29313 | (02) |