Provider Demographics
NPI:1417286873
Name:NOLAN MARX M.D.P.C.
Entity Type:Organization
Organization Name:NOLAN MARX M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NOALN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-295-3840
Mailing Address - Street 1:999 CENTRAL AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1205
Mailing Address - Country:US
Mailing Address - Phone:516-295-3840
Mailing Address - Fax:516-295-0163
Practice Address - Street 1:999 CENTRAL AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1205
Practice Address - Country:US
Practice Address - Phone:516-295-3840
Practice Address - Fax:516-295-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY91835261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2084P0800XOtherTAXONOMY
CO7488Medicare UPIN
265311Medicare PIN