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NPI Code Detail

MEDICARE: MARK JAMES GELWAN M.D

MEDICARE:   MARK JAMES GELWAN  M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician151785NY

General Provider Information

NPI Number : 1881792307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK JAMES GELWAN M.D
Provider Business Mailing Address
First Line : 12218 ROCKAWAY BEACH BLVD
Second Line :
City : BELLE HARBOR
State : NY
Zip : 11694-1836
Country : US
Telephone Number : 718-634-3300
Fax Number : 718-634-9723
Provider Business Practice Location Address
First Line : 12218 ROCKAWAY BEACH BLVD
Second Line :
City : BELLE HARBOR
State : NY
Zip : 11694-1836
Country : US
Telephone Number : 718-634-3300
Fax Number : 718-634-9723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/06/2023

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