Provider Demographics
NPI:1932293438
Name:MARCUS, JOSEH C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEH
Middle Name:C
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 1:16 DEVONSHIRE LANE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1338
Mailing Address - Country:US
Mailing Address - Phone:516-482-7818
Mailing Address - Fax:516-482-7818
Practice Address - Street 1:16 DEVONSHIRE LANE
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1338
Practice Address - Country:US
Practice Address - Phone:516-482-7818
Practice Address - Fax:516-482-7818
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133938174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY27D151Medicare ID - Type Unspecified