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General NPI Number Information
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NPI Number | 1447517883
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Entity Type | Individual
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Provider Name | MARK SHEYNSHTEYN D.O
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Gender | Male
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 1366 VICTORY BLVD STE A
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3948
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Country | US
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Telephone | 718-727-1366
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Fax | 718-727-5041
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Provider Business Mailing Address
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Address Line | 963 RATHBUN AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10309-2224
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Country | US
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Telephone | 347-615-6331
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 77673
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 279051
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License Number State | NY
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