Provider Demographics
NPI:1225208572
Name:SERGIU MARCUS, M.D., P.C.
Entity Type:Organization
Organization Name:SERGIU MARCUS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-482-5937
Mailing Address - Street 1:66 CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1030
Mailing Address - Country:US
Mailing Address - Phone:516-467-5078
Mailing Address - Fax:516-773-4125
Practice Address - Street 1:140 E 80TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0306
Practice Address - Country:US
Practice Address - Phone:516-467-5078
Practice Address - Fax:212-772-6944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150467207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00993375Medicaid
NYWEV931Medicare PIN