Provider Demographics
NPI:1255393567
Name:EPSTEIN, MARK D (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 MOTOR PKWY STE B-12
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-5113
Mailing Address - Country:US
Mailing Address - Phone:631-689-1902
Mailing Address - Fax:631-689-1153
Practice Address - Street 1:200 MOTOR PKWY STE B-12
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-5113
Practice Address - Country:US
Practice Address - Phone:631-689-1902
Practice Address - Fax:631-689-1153
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2021-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1953722082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF32847Medicare UPIN
NY40J441Medicare PIN