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

KENNETH ANDRE MARK, M.D.

Active Sole Proprietor

KENNETH ANDRE MARK, M.D. is a Obesity Medicine healthcare provider located in SOUTHAMPTON, New York. NPI 1538199310 is currently active in the NPPES registry. Verify at CMS.

Obesity Medicine · SOUTHAMPTON, NY

Registration Details

NPI Number
1538199310
Provider Type
Individual
Gender
Male
NPI Issued
Jul 4, 2006 (20.140812706095 yrs)
Last Updated
Sep 12, 2012
Licenses
204164 (NY)
204164 (NY)
204164 (NY)
Sole Proprietor
Yes

Practice Information

Address
365 COUNTY ROAD 39A
SUITE 14
SOUTHAMPTON, NY, 119685284
Browse NY providers · Browse ZIP 11968
Phone
6312830002
Fax
6312831932
Primary Specialty
Obesity Medicine
207ND0101X
Additional Specialty
Dermatology
Additional Specialty
Procedural Dermatology
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.