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Individual

MARK HERSKOVITS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO PD

Contact information

Practice address
8900 VAN WYCK EXPRESSWAY, JAMAICA, NY 11418
(718) 206-7794
(718) 206-6145
Mailing address
80 MARCUS DR, MELVILLE, NY 11747-4230
(631) 391-8366
(631) 454-4163

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
209110
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
H47691
NY
Enumeration date
03/24/2006
Last updated
02/01/2013
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