Individual
DR. JEFFREY M STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1 DUNCAN PL, OCEANSIDE, NY 11572-1306
(516) 764-3500
(516) 536-4236
Mailing address
1 DUNCAN PL, OCEANSIDE, NY 11572-1306
(516) 764-3500
(516) 536-4236
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
NOO3165-1
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
N003165-1
NY
Other
Enumeration date
06/17/2005
Last updated
05/06/2010
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