Individual
DR. MARK CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
230 CENTRAL PARK W, NEW YORK, NY 10024-6029
(212) 787-9083
Mailing address
230 CENTRAL PARK W, NEW YORK, NY 10024-6029
(212) 787-9083
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
128000
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00305537
—
NY
Enumeration date
10/16/2007
Last updated
12/26/2013
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