Basic Information
| Provider Information | |||||||||
| NPI: | 1124226394 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HORNYAK | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 TOWNE PARK PLZ | ||||||||
| Address2: | |||||||||
| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063602247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6075473334 | ||||||||
| FaxNumber: | 6075474067 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 ATWELL RD | ||||||||
| Address2: | |||||||||
| City: | COOPERSTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 133261301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6075473334 | ||||||||
| FaxNumber: | 6075474067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 02/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 62295 | CT | Y | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 4301090199 | MI | N | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.