Individual
MARC BRETT MISHKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
(585) 637-4990
Mailing address
745 POST RD, THE HEALTHY CHILD, DARIEN, CT 06820
(203) 655-6000
(203) 655-6003
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
241051
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10449602
CAQH #
NY
Enumeration date
08/22/2006
Last updated
05/18/2015
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