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NPI Code Detail

MEDICARE: DR. MARK DOUGLAS AIERSTOK MD

MEDICARE:  DR. MARK DOUGLAS AIERSTOK  MD
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
1207X00000XOrthopaedic Surgery Physician238646NY
2207X00000XOrthopaedic Surgery Physician017655ME
3207XX0005XSports Medicine (Orthopaedic Surgery) Physician238646NY

Other Identifiers

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

General Provider Information

NPI Number : 1881677417
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK DOUGLAS AIERSTOK MD
Provider Business Mailing Address
First Line : 1910 SOUTH RD
Second Line :
City : POUGHKEEPSIE
State : NY
Zip : 12601-6027
Country : US
Telephone Number : 845-454-0120
Fax Number : 845-454-6080
Provider Business Practice Location Address
First Line : 1910 SOUTH RD
Second Line :
City : POUGHKEEPSIE
State : NY
Zip : 12601-6027
Country : US
Telephone Number : 845-454-0120
Fax Number : 845-454-6080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 01/23/2014

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