Provider Demographics
NPI:1972582583
Name:MARCUS, DAVID LLOYD (PHD LCSW)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LLOYD
Last Name:MARCUS
Suffix:
Gender:M
Credentials:PHD LCSW
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:LLOYD
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD LCSW
Mailing Address - Street 1:425 MAIN ST
Mailing Address - Street 2:APT 3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0238
Mailing Address - Country:US
Mailing Address - Phone:212-777-8222
Mailing Address - Fax:212-263-6271
Practice Address - Street 1:425 MAIN ST
Practice Address - Street 2:APT 3C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0238
Practice Address - Country:US
Practice Address - Phone:212-777-8222
Practice Address - Fax:212-263-6271
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0715701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNH 5742Medicare PIN
NYNH 5741Medicare PIN