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Individual

MARK DASHEVSKIY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
2015 GRAND CONCOURSE, BRONX, NY 10453-4303
(718) 299-7295
(718) 299-6797
Mailing address
3198 GRAND CONCOURSE, BRONX, NY 10458-1000
(718) 618-0401
(718) 795-4394

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
223331
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02238324
NY
Enumeration date
09/22/2006
Last updated
09/29/2015
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