Provider Demographics
NPI:1831228238
Name:DR. MARK ARONSON, DPM PLLC
Entity type:Organization
Organization Name:DR. MARK ARONSON, DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:ARONSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-445-8550
Mailing Address - Street 1:18507 64TH AVE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-2707
Mailing Address - Country:US
Mailing Address - Phone:718-445-8550
Mailing Address - Fax:718-445-7123
Practice Address - Street 1:18507 64TH AVE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-2707
Practice Address - Country:US
Practice Address - Phone:718-445-8550
Practice Address - Fax:718-445-7123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-04
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004867213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5417020001Medicare NSC
NYU35529Medicare UPIN
NY02367AMedicare ID - Type Unspecified