Individual
MR. MARK JOSEPH MIFSUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.T.R.
Contact information
Practice address
75-20 ASTORIA BLVD., SUITE 220, JACKSON HEIGHTS, NY 11370
(917) 647-9458
Mailing address
PO BOX 1138, GLEN ROCK, NJ 07452-1138
(917) 647-9458
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
002571
NY
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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