Organization
MARK GVENTER DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK GVENTER D.P.M. (PRESIDENT)
(718) 265-1140
Entity
Organization
Contact information
Practice address
2965 OCEAN PKWY, SUITE # 403, BROOKLYN, NY 11235-8014
(718) 265-1140
(718) 648-2211
Mailing address
286 CORBIN PL, APT# 6E, BROOKLYN, NY 11235-4948
(718) 265-1140
(718) 648-2211
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N002605
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00415018
—
NY
01
—
0085809
GHI
NY
01
—
1000006367901
AMERICHOICE
NY
01
—
2210604
AETNA
NY
01
—
336060101
HEALTHPLUS
NY
01
—
63679
UNITED HEALTHCARE
NY
01
—
P618996
OXFORD
NY
Enumeration date
02/05/2008
Last updated
01/24/2011
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