Provider Demographics
NPI:1912958869
Name:DANZIGER, MARC D (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:D
Last Name:DANZIGER
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:1978 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4111
Practice Address - Country:US
Practice Address - Phone:914-737-8675
Practice Address - Fax:914-737-6016
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2018-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY196895208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01977513Medicaid
NYG75975Medicare UPIN
NY61T901Medicare ID - Type UnspecifiedMEDICARE ID