Organization
MARK FAGELMAN, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK FAGELMAN M.D. (UROLOGIST)
(845) 354-5800
Entity
Organization
Contact information
Practice address
11 MEDICAL PARK DR, SUITE 101, POMONA, NY 10970-3559
(845) 354-5800
(845) 354-5966
Mailing address
11 MEDICAL PARK DRIVE, SUITE 101, POMONA, NY 10970
(845) 354-5800
(845) 354-5966
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
102803
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00178047
—
NY
05
—
02154667
—
NY
Enumeration date
08/21/2008
Last updated
08/21/2008
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