Healthcare Provider Details

I. General information

NPI: 1265492235
Provider Name (Legal Business Name): GARY DAVID MARKOWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 WESTFALL RD STE A205
ROCHESTER NY
14618-2680
US

IV. Provider business mailing address

919 WESTFALL RD STE A205
ROCHESTER NY
14618-2680
US

V. Phone/Fax

Practice location:
  • Phone: 585-244-2580
  • Fax: 585-244-3741
Mailing address:
  • Phone: 585-244-2580
  • Fax: 585-244-3741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number197887
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number197887
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: