Provider Demographics
NPI:1417493511
Name:MARKOWITZ, BETH
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:MARKOWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 CORNELL AVE
Mailing Address - Street 2:APT 12
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1262
Mailing Address - Country:US
Mailing Address - Phone:415-863-4337
Mailing Address - Fax:
Practice Address - Street 1:407 CORNELL AVE
Practice Address - Street 2:APT 12
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1262
Practice Address - Country:US
Practice Address - Phone:415-863-4337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist