Provider Demographics
NPI:1265753784
Name:MARCINKOWSKI, AMY (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MARCINKOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 PROSPECT AVE
Mailing Address - Street 2:MEDICAL EDUCATION
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1807
Mailing Address - Country:US
Mailing Address - Phone:315-448-5537
Mailing Address - Fax:315-448-6313
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:MEDICAL EDUCATION
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-448-5537
Practice Address - Fax:315-448-6313
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2626352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology