Provider Demographics
NPI:1770594376
Name:MARCOVICI, ELI (MD)
Entity type:Individual
Prefix:
First Name:ELI
Middle Name:
Last Name:MARCOVICI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1090 AMSTERDAM AVENUE
Mailing Address - Street 2:SUITE 9A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-662-0399
Mailing Address - Fax:212-662-0259
Practice Address - Street 1:1090 AMSTERDAM AVE
Practice Address - Street 2:SUITE 9A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1737
Practice Address - Country:US
Practice Address - Phone:212-662-0399
Practice Address - Fax:212-662-0259
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2012-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY133044207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00773895Medicaid
NYA400063531OtherMEDICARE ID
NYB10719Medicare UPIN