Provider Demographics
NPI:1487825949
Name:MARKUS QUENTIN CARTER
Entity Type:Organization
Organization Name:MARKUS QUENTIN CARTER
Other - Org Name:MASSAGEWORKS OF SYRACUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARKUS
Authorized Official - Middle Name:QUENTIN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:315-317-2246
Mailing Address - Street 1:116 MILDRED AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-3212
Mailing Address - Country:US
Mailing Address - Phone:315-317-2246
Mailing Address - Fax:
Practice Address - Street 1:1110 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-2102
Practice Address - Country:US
Practice Address - Phone:315-317-2246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15117261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service