Provider Demographics
NPI:1366488025
Name:HITE, MARK H (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:H
Last Name:HITE
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 1:535 BAY RD
Mailing Address - Street 2:#1
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-3018
Mailing Address - Country:US
Mailing Address - Phone:518-793-0331
Mailing Address - Fax:518-793-7986
Practice Address - Street 1:535 BAY RD
Practice Address - Street 2:#1
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-3018
Practice Address - Country:US
Practice Address - Phone:518-793-0331
Practice Address - Fax:518-793-7986
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192539-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY17014OtherMVP
NY000411987001OtherBLUE SHIELD OF NENY
NY10000896OtherCDPHP
NY000411987001OtherBLUE SHIELD OF NENY
NY39071EMedicare ID - Type Unspecified