Provider Demographics
NPI:1760557268
Name:MARK NYITRAY DO, PLLC
Entity Type:Organization
Organization Name:MARK NYITRAY DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:
Authorized Official - Last Name:NYITRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-796-9595
Mailing Address - Street 1:57 MEETING LN
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-6254
Mailing Address - Country:US
Mailing Address - Phone:516-796-9595
Mailing Address - Fax:516-579-6510
Practice Address - Street 1:57 MEETING LN
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-6254
Practice Address - Country:US
Practice Address - Phone:516-796-9595
Practice Address - Fax:516-579-6510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203692207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3771928-2Other1199 NATIONAL BENEFIT
NY4C1284OtherGUARDIAN PHCS
NY5C9925OtherHEALTHNET
NY7893056OtherAETNA HEALTHCARE
NY2285425OtherAETNA
NYP1852941OtherOXFORD
NY0137282OtherGHI
NY2005884385OtherMAGNACARE
NY02908863Medicaid
NY6626841-004OtherCIGNA HEALTHCARE
NY6626841-004OtherCIGNA HEALTHCARE
NY=========OtherBEECH STREET
NY2285425OtherAETNA
NY=========OtherBEECH STREET