Provider Demographics
NPI:1841451937
Name:MARCUS, EDWARD I (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:I
Last Name:MARCUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:66 CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1030
Mailing Address - Country:US
Mailing Address - Phone:212-772-2500
Mailing Address - Fax:212-772-6944
Practice Address - Street 1:140 E 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0306
Practice Address - Country:US
Practice Address - Phone:212-772-2500
Practice Address - Fax:212-772-6944
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301100076207W00000X
NY255287207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P30630801Medicare PIN