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General NPI Number Information
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NPI Number | 1023347473
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Entity Type | Individual
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Provider Name | MENACHEM MARK DARWISH DDS
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Gender | Male
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Dates
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Enumeration Date | 12/14/2009
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Last Update Date | 12/14/2009
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Provider Practice Location Address
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Address Line | 14102 JEWEL AVE
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City | FLUSHING
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State | NY
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Zip | 11367-1618
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Country | US
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Telephone | 917-674-8272
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Fax |
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Provider Business Mailing Address
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Address Line | 4 4TH RD
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City | GREAT NECK
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State | NY
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Zip | 11021-1506
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Country | US
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Telephone | 917-674-8272
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 32504
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License Number State | NY
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