Individual
MARK PRESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
60 WESTWOOD AVE, STE 200, WATERBURY, CT 06708
(203) 574-5501
(203) 596-0912
Mailing address
60 WESTWOOD AVE, STE 200, WATERBURY, CT 06708
(203) 574-5501
(203) 596-0912
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
040237
CT
207VG0400X
Gynecology Physician
040237
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001402370
—
CT
Enumeration date
10/05/2006
Last updated
11/26/2013
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