Individual
MARK S ITZKOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTER, BURLINGTON, MA 01805-0001
(781) 744-7012
(781) 744-5246
Mailing address
41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTER, BURLINGTON, MA 01805-0001
(781) 744-7012
(781) 744-5246
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
160775
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
160775
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160775
MA LICENSE NUMBER
MA
Enumeration date
06/05/2006
Last updated
11/14/2017
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