Individual
MARK GIFEISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3202
(203) 688-4242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35082834
OH
207L00000X
Anesthesiology Physician
040863
CT
207L00000X
Anesthesiology Physician
35082834
OH
207L00000X
Anesthesiology Physician
Primary
MD439852
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03206888
—
NY
05
—
102445955
—
PA
05
—
2416648
—
OH
Enumeration date
06/18/2006
Last updated
03/30/2022
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