Individual
DR. SAMUEL N. MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
C/O DR ABDULLA. MEDICAL CLINIC, 12 NORTH 7TH AVE, MOUNT VERNON, NY 10550
(609) 582-8581
Mailing address
28 SEVEN OAKS LN, NANUET, NY 10954-3523
(609) 582-8581
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
160659
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00925764
—
NY
Enumeration date
06/30/2006
Last updated
06/12/2020
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