Healthcare Provider Details

I. General information

NPI: 1659957371
Provider Name (Legal Business Name): ELI MARTIN SEPKOWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 13TH ST FL 6
NEW YORK NY
10011-7702
US

IV. Provider business mailing address

200 W 13TH ST FL 6
NEW YORK NY
10011-7702
US

V. Phone/Fax

Practice location:
  • Phone: 646-665-6824
  • Fax:
Mailing address:
  • Phone: 646-665-6824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number329591
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: