# MARK E PRUZANSKY MD PC

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

## Provider details

- **NPI number:** 1922270883
- **Authorized official:** MS. ANNA PETITO PA/C (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (212) 249-8700

## Contact information

- **Practice address:** 975 PARK AVE, 1B, NEW YORK, NY 10028-0323
- **Practice address phone:** (212) 249-8700
- **Practice address fax:** (212) 327-4405
- **Mailing address:** 975 PARK AVE, 1B, NEW YORK, NY 10028-0323
- **Mailing address phone:** (212) 249-8700
- **Mailing address fax:** (212) 327-4405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 009911 | NY | Yes |

## Other

- **Enumeration date:** 03/31/2008
- **Last updated:** 03/31/2008