Provider Demographics
NPI:1306847405
Name:AZBEL, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:AZBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1379 54TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4259
Mailing Address - Country:US
Mailing Address - Phone:718-436-1600
Mailing Address - Fax:718-436-2085
Practice Address - Street 1:1379 54TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4259
Practice Address - Country:US
Practice Address - Phone:718-436-1600
Practice Address - Fax:718-436-2085
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02319684Medicaid
NYH77918Medicare UPIN
NY62S411Medicare ID - Type Unspecified