Basic Information
| Provider Information | |||||||||
| NPI: | 1922062504 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOY | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 POLY PLACE | ||||||||
| Address2: | VANYHHS BROOKLYN CAMPUS | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188366600 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 800 POLY PLACE | ||||||||
| Address2: | VANYHHS BROOKLYN CAMPUS | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188366600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 07/12/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 149748 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.