Individual
DR. RON MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2103 DEER PARK AVE, DEER PARK, NY 11729-1319
(631) 574-2060
Mailing address
2103 DEER PARK AVE, DEER PARK, NY 11729-1319
(631) 574-2060
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
214773
NY
2085R0202X
Diagnostic Radiology Physician
36126885
IL
2085R0202X
Diagnostic Radiology Physician
TM2010-0634
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02583631
—
NY
01
—
P00221729
RAILROAD MEDICARE
NY
Enumeration date
07/28/2005
Last updated
06/17/2025
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