Healthcare Provider Details

I. General information

NPI: 1750365318
Provider Name (Legal Business Name): DAVID MARSHAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 PELHAM PKWY N
BRONX NY
10467-9506
US

IV. Provider business mailing address

603 W 115TH ST # 350
NEW YORK NY
10025-7722
US

V. Phone/Fax

Practice location:
  • Phone: 718-881-4100
  • Fax: 718-881-4101
Mailing address:
  • Phone: 718-881-4100
  • Fax: 718-881-4101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number200019-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA08033900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number200019-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number25MA08033900
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number200019-1
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA08033900
License Number StateNJ
# 7
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number200019-1
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number25MA08033900
License Number StateNJ
# 9
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number200019-1
License Number StateNY
# 10
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MA08033900
License Number StateNJ
# 11
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number200019-1
License Number StateNY
# 12
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number200019-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: