Provider Demographics
NPI:1912278136
Name:MARKS, JAIME (LAC)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 WESTCHESTER AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2551
Mailing Address - Country:US
Mailing Address - Phone:917-747-7732
Mailing Address - Fax:
Practice Address - Street 1:2900 WESTCHESTER AVE STE 205
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2551
Practice Address - Country:US
Practice Address - Phone:917-747-7732
Practice Address - Fax:212-979-8520
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0047461171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist