Provider Demographics
NPI:1841216686
Name:MARKOWITZ, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MARKOWITZ
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 1:104 W MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MERCHANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-2051
Mailing Address - Country:US
Mailing Address - Phone:856-317-0666
Mailing Address - Fax:856-317-9116
Practice Address - Street 1:104 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MERCHANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08109-2051
Practice Address - Country:US
Practice Address - Phone:856-317-0666
Practice Address - Fax:856-317-9116
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA055738208100000X
PAMD045054E208100000X
DEC1-0003936208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7199406Medicaid
NJ650437Medicare PIN
PA071948RYOMedicare PIN
F32333Medicare UPIN