Individual
MARK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 UNION SQ E, BIMC DEPT OF PLASTIC SURGERY, NEW YORK, NY 10003-3314
(212) 844-8784
Mailing address
PO BOX 95000-2424, PHILADELPHIA, PA 19195-2424
(212) 844-8784
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
197217
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01925882
—
NY
Enumeration date
12/06/2005
Last updated
11/07/2012
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