Mark David Wasserman (NPI# 1033176805, PAC ID# 2365490067) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1033176805 |
| PAC ID by PECOS | 2365490067 |
| Professional Enrollment ID | I20050110000661 |
| Full Name | Mark David Wasserman |
| Address |
555 Route 25a Miller Place NY 11764-2671 |
| Phone Number | 6317446666 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1974 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330185 | JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON |
| 330393 | SUNY/STONY BROOK UNIVERSITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 555 Route 25a, Miller Place, NY 11764-2671 | 6317446666 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Street Address |
555 ROUTE 25A |
| City | MILLER PLACE |
| State | NY |
| Zip | 11764-2671 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony Modesto | Optometry | 385 Route 25a 6, Miller Place, NY 11764 | |
| Dorothy A Quilty | Clinical Social Worker | 6 Griffen Ct, Miller Place, NY 11764-1431 | |
| Craig J Chamberlain | Chiropractic | 54 N Country Rd, Suite 4, Miller Place, NY 11764-1446 | |
| James V Masone | Chiropractic | 29 Miller Woods Dr, Masone Specific Chiropractic Center, Miller Place, NY 11764-1524 | |
| James Dominick Bruno | Neurology | 5 Alilah Ct, Miller Place, NY 11764-1902 | |
| Donald A Mccrea | Physical Therapy | 41 Echo Ave, Miller Place, NY 11764-2108 | |
| Jennifer J Elsholz | Chiropractic | 85 Echo Ave, Suite 4, Miller Place, NY 11764-2200 | |
| Thomas J Ianniello | Chiropractic | 93 Miller Place Rd, Miller Place, NY 11764-2406 | |
| Walter R Chomicki | Physical Therapy | Fam Physical Therapy of Miller Place PC | 275 Route 25a, Unit 45, Miller Place, NY 11764-2427 |
| Adam Ross August | Physical Therapy | Fam Physical Therapy of Miller Place PC | 275 Route 25a, Unit 45, Miller Place, NY 11764-2427 |
| Find all physicians in zip 11764 | |||
| City | MILLER PLACE |
| Zip Code | 11764 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MILLER PLACE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Mark David Wasserman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.