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General NPI Number Information
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NPI Number | 1285850693
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Entity Type | Organization
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Legal Business Name | MARK FLECKNER M.D., P.C.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 520 FRANKLIN AVE SUITE L-6
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City | GARDEN CITY
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State | NY
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Zip | 11530-5801
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Country | US
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Telephone | 516-739-5905
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Fax |
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Provider Business Mailing Address
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Address Line | 520 FRANKLIN AVE SUITE L-6
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City | GARDEN CITY
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State | NY
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Zip | 11530-5801
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Country | US
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Telephone | 516-739-5905
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK FLECKNER
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Credential | M.D.
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Telephone | 516-739-5905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 200481
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License Number State | NY
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