Individual
MARK EVAN PUGACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
560 NORTHERN BLVD, SUITE 102, GREAT NECK, NY 11021-5100
(516) 504-1600
(516) 504-6398
Mailing address
560 NORTHERN BLVD STE 102, GREAT NECK, NY 11021-5100
(516) 504-1600
(516) 504-6398
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
193865
NY
2085R0202X
Diagnostic Radiology Physician
Primary
193865
NY
Other
Enumeration date
06/09/2005
Last updated
05/07/2026
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