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NPI Profile for MARY JENSIS CARLSON D P M in WILLISTON PARK, NY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot |
213ES0131X | 48 | Podiatry |
| NPI # | 1508002783 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/18/2008 | |
| Last updated | 03/17/2009 - About 17 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MARY JENSIS-CARLSON D P M
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MARY JENSIS-CARLSON D P M