Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | F430871-1 | NY |
NPI | 1033501507 |
---|---|
Provider Name | Mark Ludwig |
First Address | Brooklyn, NY 11235-4722 |
Second Address | Brooklyn, NY 11210-5230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2015 |
Last Update Date | 20/02/2015 |