Provider Demographics
NPI:1740370816
Name:MARX, JEFFREY LOWELL (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LOWELL
Last Name:MARX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:275 MADISON AVE
Mailing Address - Street 2:SUITE 514
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1101
Mailing Address - Country:US
Mailing Address - Phone:212-338-0150
Mailing Address - Fax:212-481-9089
Practice Address - Street 1:275 MADISON AVE
Practice Address - Street 2:SUITE 514
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1101
Practice Address - Country:US
Practice Address - Phone:212-338-0150
Practice Address - Fax:212-481-9089
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY134293207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY340931Medicare ID - Type Unspecified
NYC08812Medicare UPIN