| Mkr Medical Pc | |
|
340 Dogwood Ave Ste 105 Franklin Square NY 11010-3400 | |
| (516) 307-9617 | |
| (516) 307-9621 |
| Full Name | Mkr Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 340 Dogwood Ave Ste 105, Franklin Square, New York |
| Authorized Official Name and Position | Marc Rybstein (PRESIDENT) |
| Authorized Official Contact | 5163079618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mkr Medical Pc 340 Dogwood Ave Ste 105 Franklin Square NY 11010-3400 Ph: (516) 307-9617 | Mkr Medical Pc 340 Dogwood Ave Ste 105 Franklin Square NY 11010-3400 Ph: (516) 307-9617 |
| NPI Number | 1417371774 |
|---|---|
| Provider Enumeration Date | 02/06/2014 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 8527291962 |
|---|---|
| Medicare Enrollment ID | O20140509000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417371774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 253288 (New York) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 253288 (New York) | Primary |
| Provider Name | Marc K Rybstein |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538393822 PECOS PAC ID: 4082768775 Enrollment ID: I20090819000150 |
| Provider Name | Maria Elena Villavieja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053462523 PECOS PAC ID: 9830465269 Enrollment ID: I20171030001927 |
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