Individual
MR. MARK SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS RPA-C
Contact information
Practice address
423 EAST 23RD ST, NEW YORK, NY 10010-5011
(212) 951-3394
(212) 951-6825
Mailing address
869 EAST 38TH ST, BROOKLYN, NY 11210-3537
(347) 750-5247
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
011650
NY
Other
Enumeration date
11/24/2006
Last updated
07/08/2007
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