Individual
MR. MARK EDWARD STUTZMANN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
100 E 77TH ST, NEW YORK, NY 10075-1850
(516) 384-9965
Mailing address
9 W OAK HILL DR, OYSTER BAY, NY 11771-3908
(516) 384-9965
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
031347
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/25/2023
Last updated
05/09/2024
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