# MARK MEDICAL CARE QUEENS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174083828
- **Authorized official:** DR. RON MARK MD (PRESIDENT/OWNER)
- **Authorized official phone:** (631) 574-2060

## Contact information

- **Practice address:** 6405 WOODSIDE AVE, WOODSIDE, NY 11377-3654
- **Practice address phone:** (877) 376-2751
- **Practice address fax:** (877) 673-8535
- **Mailing address:** 6 ANNETTE WAY, JERICHO, NY 11753-2836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/20/2019
- **Last updated:** 03/20/2019