Provider Demographics
NPI:1467428573
Name:HORNFELD, MARK LOUIS (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:LOUIS
Last Name:HORNFELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:125 W 79TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6454
Mailing Address - Country:US
Mailing Address - Phone:212-580-8881
Mailing Address - Fax:844-403-8059
Practice Address - Street 1:125 W 79TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6454
Practice Address - Country:US
Practice Address - Phone:212-580-8881
Practice Address - Fax:844-403-8059
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY179425207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01693597Medicaid
NY01G93567Medicaid
F79589Medicare UPIN