Individual
DR. MARY VESONIARAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
256 MASON AVE, STATEN ISLAND, NY 10305-3408
(718) 226-6400
(718) 226-6404
Mailing address
1 EDGEWATER ST, SUITE 732, STATEN ISLAND, NY 10305-4900
(718) 226-1013
(718) 226-1039
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
125343
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00582527
—
NY
Enumeration date
12/05/2005
Last updated
07/08/2007
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