Provider Demographics
NPI:1710179114
Name:MENKOWITZ, MARC SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:SCOTT
Last Name:MENKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1131 BROAD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4329
Mailing Address - Country:US
Mailing Address - Phone:732-380-1212
Mailing Address - Fax:
Practice Address - Street 1:1131 BROAD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4329
Practice Address - Country:US
Practice Address - Phone:732-380-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY243004207XS0117X
NJ25MA07684500207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine