Provider Demographics
NPI:1679597744
Name:MARCUS, NORMAN (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:
Last Name:MARCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E 40TH ST
Mailing Address - Street 2:STE 1100
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1201
Mailing Address - Country:US
Mailing Address - Phone:212-532-7999
Mailing Address - Fax:212-532-5957
Practice Address - Street 1:30 E 40TH ST
Practice Address - Street 2:STE 1100
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1201
Practice Address - Country:US
Practice Address - Phone:212-532-7999
Practice Address - Fax:212-532-5957
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102747208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAM5025019OtherDEA
NY841441Medicare ID - Type Unspecified
NYC12206Medicare UPIN