Provider Demographics
NPI:1639466931
Name:MARKS, DANIELLE M (MS)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:M
Last Name:MARKS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CHESEBROUGH STREET
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1709
Mailing Address - Country:US
Mailing Address - Phone:917-284-7744
Mailing Address - Fax:
Practice Address - Street 1:33 CHESEBROUGH STREET
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-1709
Practice Address - Country:US
Practice Address - Phone:917-284-7744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool