Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Mark David Fagala, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629771720

Dr. Mark David Fagala, MD is a Student in an Organized Health Care Education/Training Program in Staten Island, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

242 Mason Ave Fl 1
Staten Island, NY 10305-3408
Phone: (718) 226-8630
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (NY)

Record details

NPI number1629771720
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 27, 2023
Last updated in NPPESMarch 27, 2023
Certification dateMarch 25, 2023

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