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General NPI Number Information
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NPI Number | 1497379184
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Entity Type | Individual
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Provider Name | DUSTIN H MARKS MD
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Gender | Male
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Dates
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Enumeration Date | 05/29/2020
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 116 E 68TH ST APT 1C
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City | NEW YORK
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State | NY
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Zip | 10065-5995
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Country | US
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Telephone | 212-570-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 450 BROADWAY, PAVILION C, 2ND FLOOR
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City | REDWOOD CITY
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State | CA
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Zip | 94063
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Country | US
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Telephone | 650-723-6316
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | PENDING
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT220256
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 328767
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License Number State | NY
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