Provider Demographics
NPI:1982780821
Name:MARK STEMPLER, D.P.M., P.C.
Entity Type:Organization
Organization Name:MARK STEMPLER, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:STEMPLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-667-6333
Mailing Address - Street 1:2627 HYLAN BLVD
Mailing Address - Street 2:BLDG. D
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4339
Mailing Address - Country:US
Mailing Address - Phone:718-667-6333
Mailing Address - Fax:718-987-6648
Practice Address - Street 1:2627 HYLAN BLVD
Practice Address - Street 2:BLDG. D
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4339
Practice Address - Country:US
Practice Address - Phone:718-667-6333
Practice Address - Fax:718-987-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004914213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPPWW21Medicare PIN
NY6379450001Medicare NSC