Individual
MARK FENZL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
224 E MAIN ST, SPRINGVILLE, NY 14141-1443
(716) 592-2871
Mailing address
PO BOX 1314, ORCHARD PARK, NY 14127-8314
(716) 535-0741
(716) 650-5745
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
179483
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01560085
—
NY
Enumeration date
01/30/2006
Last updated
04/23/2020
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