Individual
ANTHONEY MARK THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS IN EDUCATION
Contact information
Practice address
1424 E 101ST ST, BROOKLYN, NY 11236-5508
(347) 792-7361
Mailing address
1424 EAST 101ST STREET, BROOKLYN, NY 11236
(347) 792-7361
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1741122
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1741122
—
NY
Enumeration date
07/20/2012
Last updated
07/20/2012
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