Provider Demographics
NPI:1124226394
Name:HORNYAK, MARK J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:HORNYAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 TOWNE PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2247
Mailing Address - Country:US
Mailing Address - Phone:607-547-3334
Mailing Address - Fax:607-547-4067
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-3334
Practice Address - Fax:607-547-4067
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2019-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT62295207T00000X
MI4301090199207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P30630494Medicare PIN