# DR. MARK W DECESARE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1972584266
- **Gender:** Man
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X004697 | NY | Yes |

## Other

- **Enumeration date:** 11/14/2005
- **Last updated:** 01/19/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | GHI5803085 | GROUP HEALTH INSURANCE | NY |