Provider Demographics
NPI:1518968247
Name:MARKOWITZ, EDWARD A (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:A
Last Name:MARKOWITZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4B CHRISTOPHER COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7352
Mailing Address - Country:US
Mailing Address - Phone:203-790-9563
Mailing Address - Fax:203-778-6612
Practice Address - Street 1:46 MILL PLAIN RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-5140
Practice Address - Country:US
Practice Address - Phone:203-790-9563
Practice Address - Fax:203-778-6612
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT240111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTT22307Medicare UPIN
CT350000723Medicare ID - Type UnspecifiedMEDICARE PROVIDER #