Healthcare Provider Details

I. General information

NPI: 1245723766
Provider Name (Legal Business Name): MARK MARKLAND NP IN FAMILY HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2018
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 NOSTRAND AVE
BROOKLYN NY
11225-1510
US

IV. Provider business mailing address

114110 230TH ST
CAMBRIA HEIGHTS NY
11411-1326
US

V. Phone/Fax

Practice location:
  • Phone: 347-510-8173
  • Fax: 929-498-4420
Mailing address:
  • Phone: 347-879-3469
  • Fax: 877-794-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF340170-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK A MARKLAND
Title or Position: OWNER
Credential: FNP-BC
Phone: 347-879-3469