MEDICARE: NIKOL MARKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA003441L	PA

General Provider Information

NPI Number	:	1821068438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKOL MARKS

Provider Business Mailing Address
First Line	:	2 HOT METAL ST
Second Line	:	QUANTUM ONE, N431
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-2348
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5115 CENTRE AVE
Second Line	:	3RD FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1301
Country	:	US
Telephone Number	:	412-235-1020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	05/24/2021

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Directions to “ NIKOL MARKS ” Practice Location

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