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General NPI Number Information
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NPI Number | 1659964641
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Entity Type | Organization
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Legal Business Name | MARKFCARE
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 19 E CENTRAL AVE STE 9
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City | PEARL RIVER
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State | NY
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Zip | 10965-2355
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Country | US
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Telephone | 845-735-8181
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Fax | 845-735-8181
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Provider Business Mailing Address
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Address Line | 144 PROSPECT PLACE
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City | PEARL RIVER
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State | NY
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Zip | 10965
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Country | US
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Telephone | 914-980-0295
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Fax | 845-735-8181
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Authorized Official
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Title or Position | OWNER
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Name | MARK A FARSETTA
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Credential | LCSW
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Telephone | 914-980-0295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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