Individual
DR. MARK GVENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM, P.C.
Contact information
Practice address
2965 OCEAN PKWY, STE 403, BROOKLYN, NY 11235-8014
(718) 265-1140
(718) 648-2211
Mailing address
2965 OCEAN PKWY, STE 403, BROOKLYN, NY 11235-8014
(718) 265-1140
(718) 648-2211
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N002605
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00415018
—
NY
01
—
0085809
GHI
NY
01
—
1343406-005
CIGNA
NY
01
—
2210604
AETNA
NY
01
—
4C7517
HEALTHNET
NY
01
—
63679
UNITED HEALTHCARE
NY
01
—
A400024901
MEDICARE PTAN
NY
01
—
P618996
OXFORD
NY
Enumeration date
06/16/2005
Last updated
12/13/2010
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