Provider Demographics
NPI:1639559479
Name:MARKOWITZ, JESSE (PA)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:MARKOWITZ
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:784 FRANKLIN AVE
Mailing Address - Street 2:STE 250
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1306
Mailing Address - Country:US
Mailing Address - Phone:844-777-0910
Mailing Address - Fax:201-560-0712
Practice Address - Street 1:663 PALISADE AVE
Practice Address - Street 2:STE 302
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-3012
Practice Address - Country:US
Practice Address - Phone:201-833-9500
Practice Address - Fax:201-862-0095
Is Sole Proprietor?:No
Enumeration Date:2015-06-07
Last Update Date:2019-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00364100363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical