Provider Demographics
NPI:1013154780
Name:OFFICES OF DR. MICHAEL DEMARCO
Entity type:Organization
Organization Name:OFFICES OF DR. MICHAEL DEMARCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-343-7008
Mailing Address - Street 1:4023 KENNETT PIKE
Mailing Address - Street 2:59240
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-2018
Mailing Address - Country:US
Mailing Address - Phone:212-343-7008
Mailing Address - Fax:212-343-7008
Practice Address - Street 1:116 W 23RD ST
Practice Address - Street 2:500
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2599
Practice Address - Country:US
Practice Address - Phone:212-343-7008
Practice Address - Fax:212-343-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136106H00000X
NY2337101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty