Organization
MARK E PRUZANSKY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNA PETITO PA/C (PHYSICIAN ASSISTANT)
(212) 249-8700
Entity
Organization
Contact information
Practice address
975 PARK AVE, 1B, NEW YORK, NY 10028-0323
(212) 249-8700
(212) 327-4405
Mailing address
975 PARK AVE, 1B, NEW YORK, NY 10028-0323
(212) 249-8700
(212) 327-4405
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
009911
NY
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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