Individual
MARK S MADIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 HATFIELD LN, GOSHEN, NY 10924-6766
(845) 291-7400
(845) 291-7049
Mailing address
20 GRAND ST, FL 3, WARWICK, NY 10990-1035
(845) 294-8888
(845) 987-5979
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
149680
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00782605
—
NY
Enumeration date
07/20/2006
Last updated
07/14/2020
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