Provider Demographics
NPI:1235190117
Name:MARKUS, HOWARD E (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:E
Last Name:MARKUS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WESTFALL RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2635
Mailing Address - Country:US
Mailing Address - Phone:585-750-8094
Mailing Address - Fax:
Practice Address - Street 1:900 WESTFALL RD
Practice Address - Street 2:SUITE D
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2635
Practice Address - Country:US
Practice Address - Phone:585-750-8094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013666103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10622FCOtherPREFERRED CARE
NY0007959279OtherAETNA
NYDD1694Medicare ID - Type Unspecified