Healthcare Provider Details

I. General information

NPI: 1942388129
Provider Name (Legal Business Name): LOREN MARKS D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 57TH ST SUITE 1010
NEW YORK NY
10019-3211
US

IV. Provider business mailing address

200 W 57TH ST SUITE 1010
NEW YORK NY
10019-3211
US

V. Phone/Fax

Practice location:
  • Phone: 212-333-7300
  • Fax: 212-399-9659
Mailing address:
  • Phone: 212-333-7300
  • Fax: 212-399-9659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX003930-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: