Provider Demographics
NPI:1649340878
Name:MARKOFF, JOHN BLOCH (MSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BLOCH
Last Name:MARKOFF
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MARKED TREE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-1682
Mailing Address - Country:US
Mailing Address - Phone:508-533-2200
Mailing Address - Fax:
Practice Address - Street 1:89 MAIN ST
Practice Address - Street 2:SUITE 302A
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1815
Practice Address - Country:US
Practice Address - Phone:508-533-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1037571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P02103Medicare UPIN
MAP02103Medicare ID - Type Unspecified