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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK S POTENZA, MD

Active Sole Proprietor

MARK S POTENZA, MD is a Plastic and Reconstructive Surgery healthcare provider located in CAMILLUS, New York. NPI 1134122096 is currently active in the NPPES registry. Verify at CMS.

Plastic and Reconstructive Surgery · CAMILLUS, NY

Registration Details

NPI Number
1134122096
Provider Type
Individual
Gender
Male
NPI Issued
May 24, 2005 (21.251000550495 yrs)
Last Updated
Dec 20, 2012
License
167600 (NY)
Sole Proprietor
Yes

Practice Information

Address
5700 W GENESEE ST
STE 132
CAMILLUS, NY, 130313212
Browse NY providers · Browse ZIP 13031
Phone
3154875858
Fax
3154871950
Primary Specialty
Plastic and Reconstructive Surgery
2086S0122X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.