MEDICARE: DR. DAVID LLOYD MARCUS PH.D. LCSW

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	1041C0700X	Clinical Social Worker	071570	NY

General Provider Information

NPI Number	:	1972582583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID LLOYD MARCUS PH.D. LCSW

Provider Business Mailing Address
First Line	:	425 MAIN ST
Second Line	:	APT 3C
City	:	NEW YORK
State	:	NY
Zip	:	10044-0238
Country	:	US
Telephone Number	:	212-777-8222
Fax Number	:	212-263-6271

Provider Business Practice Location Address
First Line	:	425 MAIN ST
Second Line	:	APT 3C
City	:	NEW YORK
State	:	NY
Zip	:	10044-0238
Country	:	US
Telephone Number	:	212-777-8222
Fax Number	:	212-263-6271

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

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	05/27/2008

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