Individual
DR. MARK KIRSCHENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4406 12TH AVE, BROOKLYN, NY 11219-1094
(718) 438-4400
Mailing address
4406 12TH AVE, BROOKLYN, NY 11219-1094
(718) 438-4400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
273521
NY
208000000X
Pediatrics Physician
Primary
273521-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2011
Last updated
11/08/2018
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