Provider Demographics
NPI:1508109141
Name:MARKESIC MEDICAL, PLLC
Entity Type:Organization
Organization Name:MARKESIC MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELEONORA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKESIC
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-887-7826
Mailing Address - Street 1:150 GREENWAY TER
Mailing Address - Street 2:APT 36W
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1025
Mailing Address - Country:US
Mailing Address - Phone:917-887-7826
Mailing Address - Fax:
Practice Address - Street 1:150 GREENWAY TER
Practice Address - Street 2:APT 36W
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1025
Practice Address - Country:US
Practice Address - Phone:917-887-7826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266178-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty