Provider Demographics
NPI:1760715205
Name:MARX, ANDREW EVAN (MA/MA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:EVAN
Last Name:MARX
Suffix:
Gender:M
Credentials:MA/MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ROCKINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4757
Mailing Address - Country:US
Mailing Address - Phone:631-926-0643
Mailing Address - Fax:
Practice Address - Street 1:950 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1001
Practice Address - Country:US
Practice Address - Phone:617-441-1743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor