Individual
MARK FENSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 OCEAN PKWY, BROOKLYN, NY 11235-7745
(718) 616-4408
(718) 616-4105
Mailing address
3 HEATHER LN, LAWRENCE, NY 11559-1833
(516) 239-2677
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
172975-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01086915
—
NY
Enumeration date
07/26/2006
Last updated
07/08/2007
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