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General NPI Number Information
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NPI Number | 1063486629
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Entity Type | Individual
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Provider Name | MARK A. RAINEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 31 ARNOT RD
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City | HORSEHEADS
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State | NY
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Zip | 14845-8533
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Country | US
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Telephone | 607-739-3874
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Fax | 607-739-3632
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Provider Business Mailing Address
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Address Line | 1 GUTHRIE SQ
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City | SAYRE
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State | PA
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Zip | 18840-1625
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Country | US
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Telephone | 570-888-5858
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Fax | 570-882-3007
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 168540-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | MD031587E
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License Number State | PA
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