Provider Demographics
NPI:1043203532
Name:MARKOFF, JOSEPH I (MD PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:I
Last Name:MARKOFF
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1536
Mailing Address - Country:US
Mailing Address - Phone:215-339-8100
Mailing Address - Fax:215-421-4682
Practice Address - Street 1:1703 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-1536
Practice Address - Country:US
Practice Address - Phone:215-339-8100
Practice Address - Fax:215-421-4682
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016824E207W00000X
NJ25MA03050300207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008666880003Medicaid
128739EVTMedicare ID - Type Unspecified
PA0008666880003Medicaid