Healthcare Provider Details

I. General information

NPI: 1013154780
Provider Name (Legal Business Name): OFFICES OF DR. MICHAEL DEMARCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2009
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W 23RD ST 500
NEW YORK NY
10011-2599
US

IV. Provider business mailing address

4023 KENNETT PIKE 59240
WILMINGTON DE
19807-2018
US

V. Phone/Fax

Practice location:
  • Phone: 212-343-7008
  • Fax: 212-343-7008
Mailing address:
  • Phone: 212-343-7008
  • Fax: 212-343-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2337
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number136
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL DEMARCO
Title or Position: OWNER
Credential: PHD
Phone: 212-343-7008