Individual
MARK S POTENZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5700 W GENESEE ST, STE 132, CAMILLUS, NY 13031-3212
(315) 487-5858
(315) 487-1950
Mailing address
PO BOX 2003, EAST SYRACUSE, NY 13057-4503
(315) 449-3904
(315) 445-2936
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
167600
NY
Other
Enumeration date
05/24/2005
Last updated
12/20/2012
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