Individual
MR. MARK ANTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
824 FRANKLIN PARK DR, EAST SYRACUSE, NY 13057-1614
(315) 432-1048
(315) 432-9219
Mailing address
824 FRANKLIN PARK DR, EAST SYRACUSE, NY 13057-1614
(315) 432-1048
(315) 432-9219
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
1835571
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420837
—
NY
Enumeration date
08/11/2006
Last updated
07/08/2007
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