National Provider Identifier

Marc Brett Mishkin, MD

Marc Brett Mishkin, MD is listed in the NPPES registry with a primary specialty of Pediatrics Physician in Brockport, NY and a listed phone number of (585) 637-3905.

NPI 1609982768Brockport, NYPediatrics Physician

Profile Overview

NPI
1609982768
Provider Type
Individual
Primary Specialty
Pediatrics Physician
Enumeration Date
August 22, 2006
Last Updated
May 18, 2015

Practice Location

  • 300 West Ave
  • Brockport, NY 14420-1118

Phone: (585) 637-3905

Mailing Address

  • 745 Post RD
  • The Healthy Child
  • Darien, CT 06820

Specialties

  • Pediatrics Physician (208000000X)
Full Record
NPI
1609982768
Entity Type
Individual
Last Name
Mishkin
First Name
Marc
Middle Name
Brett
Credential
MD
Mailing Street Address
745 Post RD
Mailing Address Line 2
The Healthy Child
Mailing City
Darien
Mailing State
CT
Mailing ZIP Code
06820
Mailing Country
US
Mailing Phone
(203) 655-6000
Mailing Fax
(203) 655-6003
Practice Street Address
300 West Ave
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1118
Practice Country
US
Practice Phone
(585) 637-3905
Practice Fax
(585) 637-4990
Enumeration Date
August 22, 2006
Last Updated
May 18, 2015
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pediatrics Physician (208000000X)
Other Identifiers
10449602 (NY, Caqh #)