Individual
DR. MARC CHARLES JANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 STEVENS AVE, SUITE 109, MOUNT VERNON, NY 10550-2682
(914) 664-7311
(914) 664-2530
Mailing address
105 STEVENS AVE STE 109, MOUNT VERNON, NY 10550-2682
(914) 664-7311
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
171207
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01475350
—
NY
01
—
0D0068
PHS
—
01
—
1000017523
AFFINITY
—
01
—
1147638
UNITED
NY
01
—
133870823
POMCO
—
01
—
2900116
GHUBB
—
01
—
29430P
HIP
—
01
—
4573899
AETNA
—
01
—
552931
USHC
NY
01
—
6010835
GHL
—
01
—
79403
PHCS
—
01
—
WS889
OXFORD
NY
Enumeration date
08/20/2006
Last updated
05/15/2023
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