Provider Demographics
NPI:1710972104
Name:MARCUS, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
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 1:225 VETERANS RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4436
Mailing Address - Country:US
Mailing Address - Phone:914-302-8060
Mailing Address - Fax:914-455-2980
Practice Address - Street 1:225 VETERANS RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4436
Practice Address - Country:US
Practice Address - Phone:914-302-8060
Practice Address - Fax:914-455-2980
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124143207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
051105000017OtherFIDELISCARE PROVIDER ID#
3404474OtherAETNA HMO PROVIDER ID
10040294OtherCDPHP PROVIDER ID#
4147738OtherMVP HEALTHPLAN PIN#
5245708OtherAETNA PPO PROVIDER ID#
5C7514OtherHEALTHNET PROVIDER ID
20F211OtherEMPIRE BCBS PROVIDER ID#
4799146OtherGHI PPO PROVIDER ID #
P1975809OtherOXFORD HEALTH PROVIDER ID
5C7514OtherHEALTHNET PROVIDER ID
P1975809OtherOXFORD HEALTH PROVIDER ID