MEDICARE: DR. MARK SCHUR DC

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
1	111N00000X	Chiropractor	X0088201	NY

General Provider Information

NPI Number	:	1962574392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK SCHUR DC

Provider Business Mailing Address
First Line	:	727 N BROADWAY STE A1
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-2348
Country	:	US
Telephone Number	:	516-798-8090
Fax Number	:	516-795-3606

Provider Business Practice Location Address
First Line	:	727 N BROADWAY
Second Line	:
City	:	NORTH MASSAPEQUA
State	:	NY
Zip	:	11758-2348
Country	:	US
Telephone Number	:	516-798-8090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	10/11/2017

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