Provider Demographics
NPI:1194441279
Name:HASE, MARK (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:HASE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 ASHFORD AVE
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1812
Mailing Address - Country:US
Mailing Address - Phone:914-693-1408
Mailing Address - Fax:914-693-1409
Practice Address - Street 1:88 ASHFORD AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1812
Practice Address - Country:US
Practice Address - Phone:914-693-1408
Practice Address - Fax:914-693-1409
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor