Provider Demographics
NPI:1003951435
Name:MARCUS & SAMBERG MDS PC
Entity Type:Organization
Organization Name:MARCUS & SAMBERG MDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-874-7725
Mailing Address - Street 1:37 RIVERSIDE DRIVE
Mailing Address - Street 2:#5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-874-7725
Mailing Address - Fax:
Practice Address - Street 1:2211 BROADWAY
Practice Address - Street 2:#1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-187-4772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1386142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty