Individual
MARY L. JENSIS- CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
637 WILLIS AVE, SUITE A, WILLISTON PARK, NY 11596-1154
(516) 248-8188
Mailing address
7401 SHORE RD, APT 1H, BROOKLYN, NY 11209-1953
(718) 833-0550
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
N005090
NY
213ES0131X
Foot Surgery Podiatrist
Primary
N005090
NY
Other
Enumeration date
09/06/2006
Last updated
03/26/2009
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