Provider Demographics
NPI:1467643965
Name:MARCUSE, LARA V (MD)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:V
Last Name:MARCUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18 E 41ST ST
Mailing Address - Street 2:SUITE 1206
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6222
Mailing Address - Country:US
Mailing Address - Phone:212-725-8511
Mailing Address - Fax:
Practice Address - Street 1:403 E 34TH ST
Practice Address - Street 2:4TH FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4972
Practice Address - Country:US
Practice Address - Phone:212-263-8871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2389852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology