Individual
MARK H USOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 S MANNING BLVD, MEDICAL IMAGING DEPARTMENT, ALBANY, NY 12208-1707
(518) 525-1852
(518) 525-5187
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
208298
NY
2085R0204X
Vascular & Interventional Radiology Physician
208298
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02137846
—
NY
05
—
1017465
—
VT
Enumeration date
08/16/2005
Last updated
05/26/2021
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