Mark S Potenza
Plastic and Reconstructive Surgery
5700 W Genesee St Ste 132
Camillus
, New York 13031-3212
Mark S Potenza
Plastic and Reconstructive Surgery
5700 W Genesee St Ste 132
Camillus
, New York 13031-3212
(315) 445-2936
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- Mark S Potenza
- Po Box 2003
- East Syracuse, NY
- Zip : 13057-4503
- Fax : (315) 445-2936
- Phone : (315) 449-3904
Second Address
- Mark S Potenza
- 5700 W Genesee St Ste 132
- Camillus, NY
- Zip : 13031-3212
- Fax : (315) 487-1950
- Phone : (315) 487-5858
Reviews
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Is Mark S Potenza a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | 167600 | NY |
National Provider Identifier
| NPI | 1134122096 |
|---|---|
| Provider Name | Mark S Potenza |
| First Address | East Syracuse, NY 13057-4503 |
| Second Address | Camillus, NY 13031-3212 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/05/2005 |
| Last Update Date | 20/12/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| F31752 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.