Provider Demographics
NPI:1609975465
Name:PARNES, MARC JACOB (DO)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:JACOB
Last Name:PARNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-0392
Mailing Address - Country:US
Mailing Address - Phone:718-853-2462
Mailing Address - Fax:718-871-9090
Practice Address - Street 1:201 OCEAN PARKWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:718-853-2462
Practice Address - Fax:718-871-9090
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210518207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02059598Medicaid
16V831Medicare ID - Type Unspecified
NY02059598Medicaid