MEDICARE: JOSE MARQUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	088752	NY

General Provider Information

NPI Number	:	1285351536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE MARQUEZ

Provider Business Mailing Address
First Line	:	2860 BAILEY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-7226
Country	:	US
Telephone Number	:	718-701-5833
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 BAILEY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-7226
Country	:	US
Telephone Number	:	718-701-5833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2022
Last Update Date	:	10/26/2022

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Directions to “ JOSE MARQUEZ ” Practice Location

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