Healthcare Provider Details

I. General information

NPI: 1710972104
Provider Name (Legal Business Name): ROBERT MARCUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 VETERANS RD
YORKTOWN HEIGHTS NY
10598-4436
US

IV. Provider business mailing address

225 VETERANS RD
YORKTOWN HEIGHTS NY
10598-4436
US

V. Phone/Fax

Practice location:
  • Phone: 914-302-8060
  • Fax: 914-455-2980
Mailing address:
  • Phone: 914-302-8060
  • Fax: 914-455-2980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number124143
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: