Individual
MR. MARK MARAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-4000
Mailing address
10601 109TH AVE, OZONE PARK, NY 11417-2326
(718) 323-1180
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
021994
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021994
NEW YORK STATE REGISTRATION
NY
01
—
1151084
NCCPA ID
NY
Enumeration date
04/30/2018
Last updated
03/07/2023
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