Provider Demographics
NPI:1659310050
Name:MARCIA TAPPER M.D., LLC
Entity Type:Organization
Organization Name:MARCIA TAPPER M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-273-2540
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-0367
Mailing Address - Country:US
Mailing Address - Phone:718-273-2540
Mailing Address - Fax:
Practice Address - Street 1:11 RALPH PL
Practice Address - Street 2:SUITE 103
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4419
Practice Address - Country:US
Practice Address - Phone:718-273-2540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177241207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0499385OtherGHI
NY92H422OtherEMPIRE PPO AND HMO
NYTR7241OtherATLANTIS
NY1974863OtherUNITED
NY5830756OtherAETNA PPO
NY176772OtherELDERPLAN
NY205400101/201OtherHEALTHPLUS
NY2186510OtherAETNA HMO
NYP2018334OtherOXFORD AND OXFORD LIBERTY
NY5881672-002OtherCIGNA
NY2C1922OtherPHS AND TOUCHSTONE