Provider Demographics
NPI:1750420154
Name:MARCOS, LUIS ROJAS (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ROJAS
Last Name:MARCOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3503
Mailing Address - Country:US
Mailing Address - Phone:212-252-0443
Mailing Address - Fax:212-252-0445
Practice Address - Street 1:147 E 36TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3503
Practice Address - Country:US
Practice Address - Phone:212-252-0443
Practice Address - Fax:212-252-0445
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112316-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry