Provider Demographics
NPI:1457423931
Name:MAKMAN, MARIANNE WERTHEIM (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:WERTHEIM
Last Name:MAKMAN
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 1:46 ROGERS DR
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1013
Mailing Address - Country:US
Mailing Address - Phone:914-636-2338
Mailing Address - Fax:914-636-2773
Practice Address - Street 1:46 ROGERS DR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-1013
Practice Address - Country:US
Practice Address - Phone:914-636-2338
Practice Address - Fax:914-636-2773
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0941502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00154756Medicaid
NY509361Medicare ID - Type Unspecified
NYC-10691Medicare UPIN