Provider Demographics
NPI:1952478729
Name:ELKOWITZ, MARC JEFFREY (MD)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:JEFFREY
Last Name:ELKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:107 NORTHERN BLVD SUITE 203
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:516-773-9200
Mailing Address - Fax:516-829-3565
Practice Address - Street 1:107 NORTHERN BLVD SUITE 203
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021
Practice Address - Country:US
Practice Address - Phone:516-773-9200
Practice Address - Fax:516-829-3565
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20690122082S0105X, 2086S0122X
NJ25MA070027002082S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Not Answered2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
04328Medicare ID - Type Unspecified
H12235Medicare UPIN