National Provider Identifier Database

MARK S POTENZA, MD – NPI #1134122096
Plastic and Reconstructive Surgery


Contact Information

MARK S POTENZA, MD
5700 W GENESEE ST
STE 132
CAMILLUS, NY13031-3212
Phone: 315-487-5858
Fax: 315-487-1950
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for MARK S POTENZA

NPI Number 1134122096
Credentials MD
Entity Individual
Enumeration date 05/24/2005
Last updated 12/20/2012 - About 13 years ago
Sole proprietor1 Yes
Identifiers
  • NY License #: 167600
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for MARK S POTENZA, MD

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