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Individual
DR. MARK W DECESARE
Active
Individual
DR. MARK W DECESARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X004697
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GHI5803085
GROUP HEALTH INSURANCE
NY
Enumeration date
11/14/2005
Last updated
01/19/2010
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