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Individual
MR. MARK WILLIAM HENRY
Active
Individual
MR. MARK WILLIAM HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RPA-C, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
NULL
363A00000X
Physician Assistant
Primary
015279
NY
363A00000X
Physician Assistant
1098952
NULL
363A00000X
Physician Assistant
25MP00331900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015279
PHYSICIAN ASSISTANT
NY
01
—
1098952
NCCPA
—
Enumeration date
06/05/2006
Last updated
03/09/2016
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