Individual
DR. MARK ELLIOTT HUPART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2123 E 70TH ST, BROOKLYN, NY 11234-6101
(718) 241-2000
(718) 241-2000
Mailing address
2123 E 70TH ST, BROOKLYN, NY 11234
(718) 241-5764
(718) 241-5764
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004686
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01180363
—
NY
01
—
06719
MEDICARE GHI
NY
01
—
1306911680
MEDICARE
NY
05
—
1306911680
—
NY
Enumeration date
11/21/2006
Last updated
01/08/2018
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