Individual
DR. JEFFREY HOWARD STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6216 MYRTLE AVE, GLENDALE, NY 11385-6236
(718) 821-2161
(718) 821-1252
Mailing address
6216 MYRTLE AVE, GLENDALE, NY 11385-6236
(718) 821-2161
(718) 821-1252
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004970
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01758718
—
NY
Enumeration date
10/03/2006
Last updated
11/07/2013
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