Individual
MARK JAY KIRCHBLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 N VILLAGE AVE, SUITE 211, ROCKVILLE CTR, NY 11570-1078
(516) 764-1303
(516) 764-3618
Mailing address
2000 N VILLAGE AVE, SUITE 211, ROCKVILLE CTR, NY 11570-1078
(516) 764-1303
(516) 764-3618
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
125940
NY
Other
Enumeration date
08/02/2005
Last updated
01/22/2010
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