Individual
MARK KISSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
LIJMC DEPT. OF SURGERY VASCULAR SURGERY, 270 05 76TH AVENUE, NEW HYDE PARK, NY 11040
(718) 470-7210
Mailing address
LIJMC DEPT. OF SURGERY VASCULAR SURGERY, LIJMC DEPT. OF SURGERY VASCULAR SURGERY, NEW HYDE PARK, NY 11040
(718) 470-7210
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
224803
NY
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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