Individual
MARK FLYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 ROSE LANE, EAST ROCKAWAY, NY 11518-2129
(216) 255-5700
(216) 255-5701
Mailing address
23625 COMMERCE PARK, SUITE 204, BEACHWOOD, OH 44122-5845
(216) 255-5700
(216) 255-5701
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
183860
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01272935
—
NY
05
—
2650760
—
OH
01
—
34195845111518
TRICARE NORTH
—
01
—
926S71
EMPIRE BLUE CROSS
NY
Enumeration date
11/09/2005
Last updated
05/05/2014
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