MARK ANTOSH MD PC
NPI 1184716888
Legal Medicine in East Syracuse, NY
- Organization
- Legal Medicine
- CLIA Number: 33D0696761
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-10-2026
About MARK ANTOSH MD PC
This page provides the complete NPI Profile along with additional information for Mark Antosh Md Pc, a provider established in East Syracuse, New York operating as a Legal Medicine. The healthcare provider is registered in the NPI registry with number 1184716888 assigned on September 2006. The practitioner's primary taxonomy code is 173000000X with license number 1061151 (NY). The provider is registered as an organization and their NPI record was last updated 11 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's former legal business name is Yoffa And Antosh Md's Pc. The authorized official of this NPI record is Mark Antosh Md (President)
- NPI
- 1184716888 Verify this NPI
- Provider Legal Name
- MARK ANTOSH MD PC
- Other Organization Name
- YOFFA AND ANTOSH MD'S PC
- Other Name Type
- Former Legal Business Name (4)
- Entity Type
- Organization
- Location Address
- 824 FRANKLIN PARK DR EAST SYRACUSE, NY 13057
- Location Phone
- (315) 432-1048
- Location Fax
- (315) 432-9219
- Mailing Address
- 824 FRANKLIN PARK DR EAST SYRACUSE, NY 13057
- Mailing Phone
- (315) 432-9202
- Mailing Fax
- (315) 432-9219
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-29-2006
- Last Update Date
- 11-13-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Legal Medicine
- Taxonomy Code
- 173000000X
- Type
- Other Service Providers
- License No.
- 1061151
- License State
- NY
- Taxonomy Description
- The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| B80998 | MEDICARE UPIN (02) | NY | |
| 34271C | MEDICARE ID-TYPE UNSPECIFIED (04) | NY | |
| BB1970 | MEDICARE ID-TYPE UNSPECIFIED (04) | NY | |
| 01420837 | MEDICAID (05) | NY | |
| 00572349 | MEDICAID (05) | NY | |
| F57621 | MEDICARE UPIN (02) | NY |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 33D0696761
- Facility Type
- Physician Office
- Certificate Effective Date
- April 11, 2024
- Certificate Expiration Date
- April 10, 2026
- Laboratory Director
- DR. MARK ANTOSH
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Mark Antosh Md Pc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1184716888, enumerated as an "organization" on September 29, 2006.
The provider is located at 824 FRANKLIN PARK DR EAST SYRACUSE, NY 13057 and the phone number is (315) 432-1048.
Legal Medicine with taxonomy code 173000000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
