| Mark J. Zuckerman, Physician, P.c. | |
|
363 Route 111 Suite 102 Smithtown NY 11787-4756 | |
| (631) 360-3366 | |
| (631) 360-3380 |
| Full Name | Mark J. Zuckerman, Physician, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 363 Route 111, Smithtown, New York |
| Authorized Official Name and Position | Mark J. Zuckerman (PHYSICIAN) |
| Authorized Official Contact | 6313603366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark J. Zuckerman, Physician, P.c. 373 Route 111 Suite 20 Smithtown NY 11787-4759 Ph: (631) 360-3366 | Mark J. Zuckerman, Physician, P.c. 363 Route 111 Suite 102 Smithtown NY 11787-4756 Ph: (631) 360-3366 |
| NPI Number | 1598909780 |
|---|---|
| Provider Enumeration Date | 05/01/2009 |
| Last Update Date | 06/01/2015 |
| Medicare PECOS PAC ID | 4082765599 |
|---|---|
| Medicare Enrollment ID | O20090623000672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598909780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 171222 (New York) | Primary |
| Provider Name | Mark Zuckerman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790846244 PECOS PAC ID: 6002967510 Enrollment ID: I20090623000653 |
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