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NPI Code Detail

MEDICARE: DR. MARK VAYSMAN DPT

MEDICARE: DR. MARK VAYSMAN DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist023238NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
206768GOTHERNYGHI MEDICARE PROVIDER #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3023238OTHERNYPROFFESIONAL LICENCE

General Provider Information

NPI Number : 1699866814
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK VAYSMAN DPT
Provider Business Mailing Address
First Line : 2004 SEAGIRT BLVD
Second Line : STE 1
City : FAR ROCKAWAY
State : NY
Zip : 11691-2802
Country : US
Telephone Number : 347-244-2530
Fax Number :
Provider Business Practice Location Address
First Line : 2876 W 27TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11224-2812
Country : US
Telephone Number : 718-265-2222
Fax Number : 718-333-1023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 04/20/2016

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