Provider Demographics
NPI:1407026727
Name:TISCHLER, MARK LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:LEE
Last Name:TISCHLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 SOUND VIEW RD
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-1114
Mailing Address - Country:US
Mailing Address - Phone:610-908-4947
Mailing Address - Fax:
Practice Address - Street 1:139 N CENTRAL AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3856
Practice Address - Country:US
Practice Address - Phone:516-612-7288
Practice Address - Fax:516-612-7290
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-011913-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor