Healthcare Provider Details

I. General information

NPI: 1982770145
Provider Name (Legal Business Name): LAURA M MARKS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA M DRABKIN MD

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 POST ROAD EAST
WESTPORT CT
06880
US

IV. Provider business mailing address

1563 POST ROAD EAST
WESTPORT CT
06880
US

V. Phone/Fax

Practice location:
  • Phone: 203-319-3939
  • Fax: 203-319-3966
Mailing address:
  • Phone: 203-319-3939
  • Fax: 203-319-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number034318
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: