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General NPI Number Information
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NPI Number | 1902332018
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Entity Type | Organization
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Legal Business Name | MARC EVERETT MD P.C.
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 03/11/2023
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Provider Practice Location Address
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Address Line | 936 5TH AVE # 1
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City | NEW YORK
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State | NY
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Zip | 10021-2653
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Country | US
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Telephone | 212-774-7715
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Fax | 516-900-5022
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Provider Business Mailing Address
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Address Line | 936 5TH AVE # 1
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City | NEW YORK
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State | NY
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Zip | 10021-2653
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Country | US
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Telephone | 212-774-7715
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Fax | 516-900-5022
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Authorized Official
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Title or Position | PHYSICIAN - OWNER
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Name | DR. MARC EVERETT
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Credential | MD
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Telephone | 212-774-7715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 287559
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License Number State | NY
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