Individual
MARK WELLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
LIJMC- DIVISION OF GENERAL PEDIATRICS, 410 LAKEVILLE ROAD, NEW HYDE PARK, NY 11042
(516) 465-4377
Mailing address
LIJMC- DIVISION OF GENERAL PEDIATRICS, 410 LAKEVILLE ROAD, NEW HYDE PARK, NY 11042
(516) 465-4377
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
148531
NY
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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