Provider Demographics
NPI:1356336663
Name:GINSBURG, MARC DAVID (DPM)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:DAVID
Last Name:GINSBURG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 HACKETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12209-1525
Mailing Address - Country:US
Mailing Address - Phone:518-465-3515
Mailing Address - Fax:518-465-9857
Practice Address - Street 1:104 HACKETT BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12209-1525
Practice Address - Country:US
Practice Address - Phone:518-465-3515
Practice Address - Fax:518-465-9857
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3861213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00873872Medicaid
NYPH818OtherEMPIRE BLUE CROSS
NY10000762OtherCDPHP
T26628Medicare UPIN
NY00873872Medicaid