Healthcare Provider Details

I. General information

NPI: 1841216686
Provider Name (Legal Business Name): DAVID MARKOWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W MAPLE AVE
MERCHANTVILLE NJ
08109-2051
US

IV. Provider business mailing address

104 W MAPLE AVE
MERCHANTVILLE NJ
08109-2051
US

V. Phone/Fax

Practice location:
  • Phone: 856-317-0666
  • Fax: 856-317-9116
Mailing address:
  • Phone: 856-317-0666
  • Fax: 856-317-9116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMA055738
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD045054E
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberC1-0003936
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: