Individual
DR. MARK W DECESARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
572 ULSTER AVE, KINGSTON, NY 12401-1924
(845) 339-6000
(845) 339-6065
Mailing address
572 ULSTER AVE, KINGSTON, NY 12401-1924
(845) 339-6000
(845) 339-6065
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X004697
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GHI5803085
GROUP HEALTH INSURANCE
NY
Enumeration date
11/14/2005
Last updated
01/19/2010
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