Doctor Name: | MARK S ST. MARIE |
NPI Number: | 1629150792 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 136312 |
Business Practice Address: | 550 Orchard Park Rd Suite A101 West Seneca, NY - 142242646 |
Business Phone Number: | 7166776501 |
Business Fax Number: | 7166774706 |
Mailing Address: | 550 Orchard Park Rd, Suite A101 WEST SENECA |
State: | NY |
Postal Code: | 142242646 |
Phone Number: | 7166776501 |
Fax Number: | 7166774706 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 01/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 136312 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |