Individual
MR. RICHARD N MARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3 TECHNOLOGY DR STE 400, EAST SETAUKET, NY 11733-4078
(631) 751-8000
(631) 751-8030
Mailing address
97 WYANDANCH BLVD, SMITHTOWN, NY 11787-4293
(631) 864-8244
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002725-1
NY
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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