Provider Demographics
NPI:1972097269
Name:MARKSON, SAMANTHA SONIA (DPT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:SONIA
Last Name:MARKSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 LEXINGTON AVE APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4676
Mailing Address - Country:US
Mailing Address - Phone:732-343-0894
Mailing Address - Fax:
Practice Address - Street 1:140 SAINT EDWARDS ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3904
Practice Address - Country:US
Practice Address - Phone:718-858-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist