Individual
MARK A. HALSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3350 NOYAC RD, SAG HARBOR, NY 11963-1908
(631) 731-1099
Mailing address
3350 NOYAC RD, SAG HARBOR, NY 11963-1908
(631) 731-1099
(631) 994-3196
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
282033
NY
207NP0225X
Pediatric Dermatology Physician
282033
NY
207NS0135X
Procedural Dermatology Physician
282033
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05078079
—
NY
Enumeration date
06/10/2011
Last updated
08/05/2025
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