Provider Demographics
NPI:1003950270
Name:ANDREW M. MARKER, PSYCHOLOGIST, P.C.
Entity Type:Organization
Organization Name:ANDREW M. MARKER, PSYCHOLOGIST, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-772-6279
Mailing Address - Street 1:124 E 84TH ST
Mailing Address - Street 2:SUITE 1-B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0915
Mailing Address - Country:US
Mailing Address - Phone:212-772-6279
Mailing Address - Fax:212-772-7166
Practice Address - Street 1:124 E 84TH ST
Practice Address - Street 2:SUITE 1-B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0915
Practice Address - Country:US
Practice Address - Phone:212-772-6279
Practice Address - Fax:212-772-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005512103G00000X, 103T00000X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03196325Medicaid
NY03196325Medicaid