Individual
DR. ANDREI MARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
57 W 57TH ST, SUITE#1004, NEW YORK, NY 10019-2802
(212) 813-0707
(212) 813-0808
Mailing address
57 W 57TH ST, SUITE#1004, NEW YORK, NY 10019-2802
(212) 813-0707
(212) 813-0808
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
041022
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
041022
NY
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
041022
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112542
CIGNA HMO
NY
Enumeration date
07/26/2006
Last updated
09/11/2025
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