Individual
DR. MARK STEVEN HEFFRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
8003 211TH ST, QUEENS VILLAGE, NY 11427-1012
(718) 464-8948
(718) 740-0319
Mailing address
8003 211TH ST, QUEENS VILLAGE, NY 11427-1012
(718) 464-8948
(718) 740-0319
Taxonomy
Speciality
Code
Description
License number
State
111NR0200X
Radiology Chiropractor
Primary
X002652
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0079854
GHI PROVIDER NUMBER
NY
01
—
11-2847332
TAX ID
NY
Enumeration date
10/25/2006
Last updated
07/17/2008
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