person
Mark Theodore, FNP-BC
Family Nurse Practitioner in Utica, New York
NPI 1457793135

Mark Theodore is a Family Nurse Practitioner based in Utica, NY and is specialized in Family. Mark Theodore practices in Utica, NY and has the professional credentials of FNP-BC. The NPI Number for Mark Theodore is 1457793135 and holds a License No. 629932 (New York).

The current practice location address for Mark Theodore is 1656 Champlin Ave, Utica, NY and can be reached out via phone at 315-624-6000.

Location: 1656 Champlin Ave, Utica, NY, 13502-4830
person
Provider Profile Details
NPI Number
1457793135
Provider Name
Mark Theodore
Credential
FNP-BC
Provider Entity Type
Individual
Gender
Male
Address
1656 Champlin Ave, Utica, NY, 13502-4830
Phone Number
315-624-6000
Fax Number
Provider Enumeration Date
07/23/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1656 Champlin Ave
City
State
Zip
13502-4830
Phone Number
315-624-6000
Fax Number
person
Provider Business Mailing Address Details
Address
1656 Champlin Ave
City
State
Zip
13502-4830
Phone Number
315-624-6000
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Critical Care Medicine
Taxonomy
License No.
338083 (New York)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
629932 (New York)
Definition
Definition to come...
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