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General NPI Number Information
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NPI Number | 1992093199
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Entity Type | Organization
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Legal Business Name | MERYL SCHLUSSEL MARK MD PC
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 251 E 33RD ST 4TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10016-4804
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Country | US
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Telephone | 212-725-7585
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Fax | 212-779-8431
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Provider Business Mailing Address
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Address Line | 166 NORMA RD
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City | TEANECK
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State | NJ
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Zip | 07666-4233
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Country | US
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Telephone | 212-725-7585
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MERYL MARK
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Credential |
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Telephone | 212-725-7585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 168180-1
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License Number State | NY
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