Individual
MARK FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
234 E 149TH ST, 2C2 ROOM 445A, BRONX, NY 10451-5504
(718) 579-5000
Mailing address
115 E 116TH ST APT 5C, NEW YORK, NY 10029-1308
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A149089
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2013
Last updated
01/25/2024
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